Provider Demographics
NPI:1902919244
Name:WEALLEANS, JAMES ANDREW (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:WEALLEANS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 E SONTERRA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4278
Mailing Address - Country:US
Mailing Address - Phone:210-393-3936
Mailing Address - Fax:
Practice Address - Street 1:1314 E SONTERRA BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4278
Practice Address - Country:US
Practice Address - Phone:210-393-3936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 177461223G0001X
TX295471223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice