Provider Demographics
NPI:1245614718
Name:KELLER- WELLS & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:KELLER- WELLS & ASSOCIATES, P.C.
Other - Org Name:HORMONE THERAPY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-568-6108
Mailing Address - Street 1:PO BOX 530124
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89053-0124
Mailing Address - Country:US
Mailing Address - Phone:702-568-6108
Mailing Address - Fax:702-487-5773
Practice Address - Street 1:2637 W HORIZON RIDGE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4835
Practice Address - Country:US
Practice Address - Phone:702-568-6108
Practice Address - Fax:702-479-4881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10558207VX0000X
261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty