Provider Demographics
NPI:1538563739
Name:WELLS FAMILY PRACTICE, PLLC
Entity type:Organization
Organization Name:WELLS FAMILY PRACTICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:MUJEEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-890-3822
Mailing Address - Street 1:10311 N ELDRIDGE PKWY
Mailing Address - Street 2:SUITE B5
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5368
Mailing Address - Country:US
Mailing Address - Phone:281-830-3822
Mailing Address - Fax:281-890-3844
Practice Address - Street 1:10311 N ELDRIDGE PKWY
Practice Address - Street 2:SUITE B5
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-5368
Practice Address - Country:US
Practice Address - Phone:281-830-3822
Practice Address - Fax:281-890-3844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-16
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9517207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty