Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | Q8675 | TX |
NPI | 1316268659 |
---|---|
Provider Name | Dr. Joel Edwyn Wells |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-8883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2010 |
Last Update Date | 09/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1316268659 | STATE NPI (01) | TX |