Individual
TINA TRAHAN WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17520 OLD JEFFERSON HWY, STE. B, PRAIRIEVILLE, LA 70769-3929
(225) 673-8983
(225) 677-8983
Mailing address
PO BOX 4869, DEPARTMENT NUMBER 237, HOUSTON, TX 77210-4869
(877) 744-1141
(847) 537-4866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D22798
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080137693
RAILROAD MEDICARE
LA
05
—
1664987
—
LA
Enumeration date
07/01/2005
Last updated
03/08/2012
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