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General NPI Number Information
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NPI Number | 1053682989
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Entity Type | Individual
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Provider Name | KAREN WILSON WHEAT OT
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Gender | Female
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 808 TOWER DR SUITE 7
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City | ODESSA
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State | TX
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Zip | 79761
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Country | US
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Telephone | 432-335-8777
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Fax | 432-335-8787
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Provider Business Mailing Address
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Address Line | 801 S LOOP 250 W
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City | MIDLAND
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State | TX
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Zip | 79703-2134
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Country | US
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Telephone | 432-689-2100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 110656
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License Number State | TX
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