MEDICARE: NICHOLAS WHEELER

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	152W00000X	Optometrist	11568	TX

General Provider Information

NPI Number	:	1750245171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS WHEELER

Provider Business Mailing Address
First Line	:	5778 GROSSETO DR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-2288
Country	:	US
Telephone Number	:	513-515-9869
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 N CENTRAL EXPY STE 300
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-8803
Country	:	US
Telephone Number	:	469-298-3416
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ NICHOLAS WHEELER ” Practice Location

Language	Start Address	Practice Location

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