Provider Demographics
NPI:1275712754
Name:STEVE WELCH DESIGNS
Entity Type:Organization
Organization Name:STEVE WELCH DESIGNS
Other - Org Name:UROSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-378-7759
Mailing Address - Street 1:3138 SOUTHLAKE PARK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-2500
Mailing Address - Country:US
Mailing Address - Phone:817-366-3564
Mailing Address - Fax:
Practice Address - Street 1:3138 SOUTHLAKE PARK RD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-2500
Practice Address - Country:US
Practice Address - Phone:832-378-7759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0093762332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies