Provider Demographics
NPI:1295880235
Name:WOLFF, NELLY E (MD)
Entity type:Individual
Prefix:DR
First Name:NELLY
Middle Name:E
Last Name:WOLFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 STORIE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-2926
Mailing Address - Country:US
Mailing Address - Phone:817-516-0967
Mailing Address - Fax:817-563-2706
Practice Address - Street 1:8003 STORIE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-2926
Practice Address - Country:US
Practice Address - Phone:817-516-0967
Practice Address - Fax:817-563-2706
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8161208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics