MEDICARE: PAUL ALAN WHEELIS

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
1	183500000X	Pharmacist	TX19170	TX

General Provider Information

NPI Number	:	1225036403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL ALAN WHEELIS

Provider Business Mailing Address
First Line	:	81 OAK HILL CIR
Second Line	:
City	:	BROWNWOOD
State	:	TX
Zip	:	76801-8785
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 S PARK DR
Second Line	:
City	:	BROWNWOOD
State	:	TX
Zip	:	76801-5918
Country	:	US
Telephone Number	:	325-646-9414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

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Directions to “ PAUL ALAN WHEELIS ” Practice Location

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