Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | R6504 | TX |
NPI | 1043605454 |
---|---|
Provider Name | Dr. Michael Wheeler |
First Address | Dallas, TX 75231-4418 |
Second Address | Dallas, TX 75231-4418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2015 |
Last Update Date | 25/08/2021 |