Physician Compare National (NPI:1508802646)

HEALTHCARE PROVIDER: WENDELL GENE MCDANIEL DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1508802646
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850311499
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120314000845
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MCDANIEL
	Individual professional last name
Provider First Name	WENDELL
	Individual professional first name
Provider Middle Name	GENE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	GENE MCDANIEL DO PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0143240788
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	308 W HWY 199
	Group Practice or individual's line 1 address
City	SPRINGTOWN
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	760822631
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8175235402
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450271
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WISE REGIONAL HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450203
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEDICAL CITY WEATHERFORD
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450419
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y