Provider Demographics
NPI:1538309653
Name:WELLS, REGINA DENISE (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:DENISE
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12806 GLORYWHITE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-3685
Mailing Address - Country:US
Mailing Address - Phone:713-301-0159
Mailing Address - Fax:281-922-6448
Practice Address - Street 1:5618 E SAM HOUSTON PKWY N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-3249
Practice Address - Country:US
Practice Address - Phone:281-452-3300
Practice Address - Fax:281-452-3301
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM6949208000000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2013880Medicaid