Provider Demographics
NPI:1851379739
Name:WELLS, KENNEY HAROLD (OD)
Entity Type:Individual
Prefix:DR
First Name:KENNEY
Middle Name:HAROLD
Last Name:WELLS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17134 BULVERDE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-2190
Mailing Address - Country:US
Mailing Address - Phone:210-267-2686
Mailing Address - Fax:210-267-2216
Practice Address - Street 1:17134 BULVERDE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-2189
Practice Address - Country:US
Practice Address - Phone:210-617-3032
Practice Address - Fax:210-267-2216
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9372152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist