Individual
TRI TE
Active
Individual
TRI TE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q4311
TX
207RC0000X
Cardiovascular Disease Physician
Q4311
TX
207RI0011X
Interventional Cardiology Physician
Primary
DO3771
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360400105
—
TX
01
—
445253YLUJ
WELLMED MEDICAL GROUP
—
01
—
DO3771
STATE LICENSE
NV
Enumeration date
06/20/2015
Last updated
11/19/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up