Provider Demographics
NPI:1801894415
Name:WELLS, CHET EDWARD (MD)
Entity type:Individual
Prefix:
First Name:CHET
Middle Name:EDWARD
Last Name:WELLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-7201
Mailing Address - Country:US
Mailing Address - Phone:682-777-5870
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:SUITE 134
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8122
Practice Address - Country:US
Practice Address - Phone:972-981-7777
Practice Address - Fax:972-981-7750
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2025-05-24
Deactivation Date:2006-05-19
Deactivation Code:
Reactivation Date:2006-06-01
Provider Licenses
StateLicense IDTaxonomies
TXE6193207VM0101X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB103099Medicare PIN
TXC23329Medicare UPIN