Basic Information
| Provider Information | |||||||||
| NPI: | 1578605937 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WELLS | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | ROSE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD MPH | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WELLS DIAZ | ||||||||
| OtherFirstName: | MARGARET | ||||||||
| OtherMiddleName: | ROSE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1011 BRODIE ST SUITE 28 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787044159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124438381 | ||||||||
| FaxNumber: | 5124438381 | ||||||||
| Practice Location | |||||||||
| Address1: | 2171 B WOODWARD | ||||||||
| Address2: | CONCENTRA MEDICAL CENTER | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124400555 | ||||||||
| FaxNumber: | 5124401113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083P0500X | G2625 | TX | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine |
No ID Information.