MEDICARE: MR. BRANDON WHEELER LMFT

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	101YM0800X	Mental Health Counselor	201415	TX

General Provider Information

NPI Number	:	1225496359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRANDON WHEELER LMFT

Provider Business Mailing Address
First Line	:	2017 COLQUITT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3405
Country	:	US
Telephone Number	:	832-689-8962
Fax Number	:

Provider Business Practice Location Address
First Line	:	4115 LOU ANNE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-5136
Country	:	US
Telephone Number	:	832-689-8962
Fax Number	:

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

Provider Enumeration Date	:	02/03/2016
Last Update Date	:	02/03/2016

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Directions to “ MR. BRANDON WHEELER LMFT” Practice Location

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