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NPI Code Detail

MEDICARE: DR. KATHRYN BRELSFORD WHEELER DO

MEDICARE: DR. KATHRYN BRELSFORD WHEELER DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianR6936TX

General Provider Information

NPI Number : 1144607052
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHRYN BRELSFORD WHEELER DO
Provider Business Mailing Address
First Line : PO BOX 733784
Second Line :
City : DALLAS
State : TX
Zip : 75373-3784
Country : US
Telephone Number : 682-885-6483
Fax Number : 682-885-3113
Provider Business Practice Location Address
First Line : 5708 EDWARDS RANCH RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-4115
Country : US
Telephone Number : 817-336-4040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2015
Last Update Date : 11/22/2021

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