Waco Neonatal Group, P.a.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

H0927 Issued in TX

Legal business name

WACO NEONATAL GROUP, P.A.

Practice address

100 Hillcrest Medical Blvd
Waco, TX 76712-8897

Phone

(254) 202-2911

Fax

(254) 202-2919

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Darrell S Wheeler, M.D.

Title

President

Phone

(754) 754-0934

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366243200000",
    "number": "1265530604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 CHIMNEY RIDGE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767082368",
            "telephone_number": "254-754-0934",
            "fax_number": "254-714-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HILLCREST MEDICAL BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128897",
            "telephone_number": "254-202-2911",
            "fax_number": "254-202-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACO NEONATAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-04-18",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "754-754-0934",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "H0927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110419201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neonatal-Perinatal Medicine Physician in Waco, TX
• Providers in Waco, TX by specialty
• Neonatal-Perinatal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.