Doctor Name: | BEVERLY SKINNER-WELLS |
NPI Number: | 1295019883 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARDMS/RVT |
License Number: | 11039 |
Business Practice Address: | 1408 E Lake Dr Gladewater, TX - 756479205 |
Business Phone Number: | 9033990858 |
Business Fax Number: | 8778797379 |
Mailing Address: | 1408 E Lake Dr, GLADEWATER |
State: | TX |
Postal Code: | 756479205 |
Phone Number: | 9033990858 |
Fax Number: | 8778797379 |
NPI Enumeration Date: | 10/01/2011 |
NPI Last Update Date: | 12/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246XC2903X |
License Number: | 11039 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Spec/Tech, Cardiovascular |
Taxonomy Specialization: | Vascular Specialist |
Taxonomy Definition: |