Active NPI
Wendell George Geiger, PHYSICIAN ASSISTANT
- Physician Assistant
- Fort Worth, TX
National Provider Identifier
1417177411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA00128
- Practice address
- 2825 Stadium Drive
Fort Worth, TX 76109-1377 - Phone
- (817) 257-7940
- Fax
- (817) 257-7279
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00128 | TX | Primary |
Addresses
Primary practice location
2825 Stadium Drive
Fort Worth, TX 76109-1377
Mailing address
433 Meadowhill Drive
Benbrook, TX 76126-4016
Phone (817) 249-6341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00128 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417177411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "433 MEADOWHILL DRIVE",
"city": "BENBROOK",
"state": "TX",
"postal_code": "761264016",
"telephone_number": "817-249-6341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 STADIUM DRIVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761091377",
"telephone_number": "817-257-7940",
"fax_number": "817-257-7279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEIGER",
"first_name": "WENDELL",
"middle_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA00128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.