Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | F0348 | TX |
N | 207PE0004X | Emergency Medical Services | F0348 | TX |
Y | 207R00000X | Internist | F0348 | TX |
Y | 111NI0900X | Internist | F0348 | TX |
NPI | 1063487023 |
---|---|
Provider Name | Howard Thomas Wells |
First Address | San Antonio, TX 78229-5907 |
Second Address | San Antonio, TX 78205-1201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 19/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114709201 | (05) | TX |
8N2619 | BCBS (01) | TX |