Healthcare Provider Details

I. General information

NPI: 1740548940
Provider Name (Legal Business Name): REINA DAVIS WHEELER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN STREET
HOUSTON TX
77030
US

IV. Provider business mailing address

2306 N ALEXANDER DR
BAYTOWN TX
77520-3455
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-5800
  • Fax:
Mailing address:
  • Phone: 702-338-5326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP2630
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: