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Individual

JOE WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1010 W 40TH ST, AUSTIN, TX 78756-4010
(512) 459-8753
(512) 483-6828
Mailing address
1010 W 40TH ST, AUSTIN, TX 78756-4010
(512) 459-8753
(512) 483-6828

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
J9566
TX
2086S0129X
Vascular Surgery Physician
44430
OK
2086S0129X
Vascular Surgery Physician
Primary
J9566
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
044931601
TX
01
741796484
TAX ID NO
TX
01
89453S
BCBS PROV NO
TX
Enumeration date
07/27/2006
Last updated
01/24/2025
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