Provider Demographics
NPI:1265310791
Name:VELLOTTI, WESLEY DANIEL (APRN)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:DANIEL
Last Name:VELLOTTI
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E SYCAMORE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-5017
Mailing Address - Country:US
Mailing Address - Phone:903-202-2900
Mailing Address - Fax:
Practice Address - Street 1:230 E SYCAMORE ST STE 100
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-5017
Practice Address - Country:US
Practice Address - Phone:903-202-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1210747363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily