Provider Demographics
NPI:1780955245
Name:WELLS, SHARON (RPH)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 CANDLE TREE CV
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-2679
Mailing Address - Country:US
Mailing Address - Phone:432-235-0457
Mailing Address - Fax:
Practice Address - Street 1:1601 W WALL ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6549
Practice Address - Country:US
Practice Address - Phone:432-684-0569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-14
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24584183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist