Provider Demographics
NPI:1851408611
Name:NEWELL, WESLEY WAYNE (DDS)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:WAYNE
Last Name:NEWELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:W.
Other - Middle Name:WAYNE
Other - Last Name:NEWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:4550 POST OAK PLACE DR
Mailing Address - Street 2:SUITE 345
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3165
Mailing Address - Country:US
Mailing Address - Phone:713-622-4485
Mailing Address - Fax:713-622-2237
Practice Address - Street 1:4550 POST OAK PLACE DR
Practice Address - Street 2:SUITE 345
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3165
Practice Address - Country:US
Practice Address - Phone:713-622-4485
Practice Address - Fax:713-622-2237
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice