Provider Demographics
NPI:1669796322
Name:WELLS, KATERINA OLIVIA KIMONIS (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:KATERINA
Middle Name:OLIVIA KIMONIS
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:KETERINA
Other - Middle Name:OLIVIA
Other - Last Name:KIMONIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:2355 THOMAS AVE
Mailing Address - Street 2:APT 2210
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2352
Mailing Address - Country:US
Mailing Address - Phone:617-909-9171
Mailing Address - Fax:
Practice Address - Street 1:3409 WORTH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2029
Practice Address - Country:US
Practice Address - Phone:214-824-1730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8384208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery