Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | F7298 | TX |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | F7298 | TX |
NPI | 1023066727 |
---|---|
Provider Name | Dr. Kevin R Wheelan |
First Address | Dallas, TX 75226-1339 |
Second Address | Dallas, TX 75226-1339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 22/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
129623803 | (05) | TX |
1296238-06 | (05) | TX |
B27526 | (02) | TX |