Individual provider Active NPI

Carolyn M Wisler, MD

  • Pediatrics Physician
  • Flower Mound, TX
National Provider Identifier
1083673305
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L7006 Issued in TX
Practice address
4001 Long Prairie Rd Ste 140
Flower Mound, TX 75028-1564
Phone
(972) 691-2388
Fax
(972) 691-2766
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L7006 TX Primary

Addresses

Primary practice location

4001 Long Prairie Rd Ste 140
Flower Mound, TX 75028-1564

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Other names 1

  • Carolyn M. Leedy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071128000410 TX Practitioner - Pediatric Medicine 3375632359 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L7006TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Nov 1, 2011 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Nov 1, 2011 Accepting new patients

Locations

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1083673305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 LONG PRAIRIE RD STE 140",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281564",
            "telephone_number": "972-691-2388",
            "fax_number": "972-691-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISLER",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L7006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "LEEDY",
            "middle_name": "M.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.