Provider Demographics
NPI:1275753956
Name:WELLS, DAWN DELPHIA (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:DELPHIA
Last Name:WELLS
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Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:2570 JUSTIN RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3094
Mailing Address - Country:US
Mailing Address - Phone:972-317-3376
Mailing Address - Fax:972-317-1936
Practice Address - Street 1:2570 JUSTIN RD
Practice Address - Street 2:SUITE 160
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-3094
Practice Address - Country:US
Practice Address - Phone:972-317-3376
Practice Address - Fax:972-317-1936
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2012-06-12
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Provider Licenses
StateLicense IDTaxonomies
TXPA03729363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant