Provider Demographics
NPI:1487887980
Name:DR. ELGIN E. WELLS
Entity type:Organization
Organization Name:DR. ELGIN E. WELLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELGIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-436-5858
Mailing Address - Street 1:2251 COUNTY ROAD 94 STE 102
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5137
Mailing Address - Country:US
Mailing Address - Phone:713-436-5858
Mailing Address - Fax:713-436-4008
Practice Address - Street 1:2251 COUNTY ROAD 94 STE 102
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5137
Practice Address - Country:US
Practice Address - Phone:713-436-5858
Practice Address - Fax:713-436-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty