Provider Demographics
NPI:1376650408
Name:WALES, DENNIS S (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:S
Last Name:WALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3701 KIRBY DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3900
Mailing Address - Country:US
Mailing Address - Phone:713-798-2091
Mailing Address - Fax:713-798-3644
Practice Address - Street 1:810 E 3RD ST UNIT 201
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5759
Practice Address - Country:US
Practice Address - Phone:970-764-1790
Practice Address - Fax:970-375-7927
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2019-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL4793207Q00000X
CODR.0040200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L13220Medicare PIN
TX8L12784Medicare PIN