Individual
KEVIN DALE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
17304 PRESTON RD, SUITE 555, DALLAS, TX 75252-5618
(866) 931-8882
(972) 934-3174
Mailing address
4409 BLUE SAGE CT, NORMAN, OK 73072-3953
(405) 701-3608
(405) 310-5092
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1495
OK
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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