Individual
GLENN STEPHEN WHEELESS
Active
Individual
GLENN STEPHEN WHEELESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G0280
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
G0280
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123405606
—
TX
01
—
6484850003
MEDICARE NSC - EFFECT 02/01/2011
TX
01
—
8B7873
BLUE CROSS BLUE SHIELD
TX
01
—
8CR163
BCBS TX 02/01/2011
TX
01
—
P00935338
RAILROAD MEDICARE
TX
01
—
TXB126769
MEDICARE PART B - EFFECT. 4-20-11
TX
Enumeration date
10/12/2006
Last updated
05/22/2013
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