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NPI Code Detail

MEDICARE: DR. KENNETH WHEELER DPT, OCS, NCS

MEDICARE: DR. KENNETH WHEELER DPT, OCS, NCS
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
12251E1300XClinical Electrophysiology Physical Therapist1226699TX
22251N0400XNeurology Physical Therapist1226699TX
32251X0800XOrthopedic Physical Therapist1226699TX
4225100000XPhysical Therapist1226699TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427492941
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH WHEELER DPT, OCS, NCS
Provider Business Mailing Address
First Line : 1001 12TH AVE STE 201
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3926
Country : US
Telephone Number : 817-719-7714
Fax Number : 817-796-1114
Provider Business Practice Location Address
First Line : 1001 12TH AVE STE 201
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3946
Country : US
Telephone Number : 817-719-7714
Fax Number : 817-796-1114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2013
Last Update Date : 02/07/2024

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