Provider Demographics
NPI:1477251536
Name:WELLS, MANDY MCELROY
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:MCELROY
Last Name:WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 W FALL DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-8892
Mailing Address - Country:US
Mailing Address - Phone:361-779-0170
Mailing Address - Fax:
Practice Address - Street 1:5210 W FALL DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-8892
Practice Address - Country:US
Practice Address - Phone:361-779-0170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant