Individual
HEATHER J WELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA04349
TX
363AM0700X
Medical Physician Assistant
PA04349
TX
363AS0400X
Surgical Physician Assistant
Primary
PA04349
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699746594
NPI
TX
01
—
5840300001
MEDICARE DME
TX
01
—
714812
MEDICARE PART B
TX
01
—
835N05
BCBS TX 02/01/2011
TX
01
—
8Y1402
BCBS TEXAS NUMBER
TX
01
—
P00684449
RAILROAD MEDICARE
TX
01
—
P00954369
RAILROAD MEDICARE
TX
01
—
TXB120923
MEDICARE PART B - EFFECT 02/01/2011
TX
Enumeration date
01/30/2006
Last updated
12/03/2025
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