Individual
BEVERLY SKINNER-WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARDMS/RVT
Contact information
Practice address
1408 E LAKE DR, GLADEWATER, TX 75647-9205
(903) 399-0858
(877) 879-7379
Mailing address
1408 E LAKE DR, GLADEWATER, TX 75647-9205
(903) 399-0858
(877) 879-7379
Taxonomy
Speciality
Code
Description
License number
State
246XC2903X
Vascular Specialist/Technologist Cardiovascular
11039
TX
246XS1301X
Sonography Specialist/Technologist Cardiovascular
11039
TX
2471C3402X
Radiography Radiologic Technologist
11039
TX
2471S1302X
Sonography Radiologic Technologist
Primary
11039
TX
2471V0105X
Vascular Sonography Radiologic Technologist
11039
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11039
ARDMS-RVT
TX
Enumeration date
10/01/2011
Last updated
12/04/2012
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