Organization
WACO NEONATAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL S WHEELER M.D. (PRESIDENT)
(754) 754-0934
Entity
Organization
Contact information
Practice address
100 HILLCREST MEDICAL BLVD, WACO, TX 76712-8897
(254) 202-2911
(254) 202-2919
Mailing address
3740 CHIMNEY RIDGE DR, WACO, TX 76708-2368
(254) 754-0934
(254) 714-0650
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
H0927
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110419201
—
TX
Enumeration date
09/20/2006
Last updated
04/18/2013
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