Provider Demographics
NPI:1275008682
Name:WELCH, REGINA VIOLA (DNP, MSN, AG-ACNP-BC)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:VIOLA
Last Name:WELCH
Suffix:
Gender:F
Credentials:DNP, MSN, AG-ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 WHITE OAK RUN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-2742
Mailing Address - Country:US
Mailing Address - Phone:501-454-3302
Mailing Address - Fax:
Practice Address - Street 1:16750 RED OAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2543
Practice Address - Country:US
Practice Address - Phone:281-453-7110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAPI137712363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner