Provider Demographics
NPI:1154474336
Name:WELLONS, APRIL (OD)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:WELLONS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11103 WEST AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1370
Mailing Address - Country:US
Mailing Address - Phone:210-524-6509
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:7000 ARUNDEL MILLS CIR
Practice Address - Street 2:SPACE 229
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1282
Practice Address - Country:US
Practice Address - Phone:410-799-2770
Practice Address - Fax:410-799-4328
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDTA1709152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU99925Medicare UPIN
MD501M1702Medicare PIN