Provider Demographics
NPI:1861853392
Name:WELLS, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
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 1:7676 HILLMONT ST
Mailing Address - Street 2:STE 105
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6400
Mailing Address - Country:US
Mailing Address - Phone:346-571-4171
Mailing Address - Fax:
Practice Address - Street 1:7676 HILLMONT ST
Practice Address - Street 2:STE 105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6400
Practice Address - Country:US
Practice Address - Phone:346-571-4171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health