Individual provider Active NPI

Haley Diane Brennan, PA-C

  • Medical Physician Assistant
  • Midland, TX
National Provider Identifier
1528430865
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10201 Issued in TX
Practice address
4705 Briarwood Ave
Midland, TX 79707-2639
Phone
(325) 054-1454
Fax
(833) 941-0864
NPI assigned
Oct 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10201 TX Primary

Addresses

Primary practice location

4705 Briarwood Ave
Midland, TX 79707-2639

Mailing address

4705 Briarwood Ave
Midland, TX 79707-2639
Phone (325) 054-1454

Other practice location 1

6301 Andrews Hwy
Midland, TX 79706-3147
Phone (432) 505-4147

Other practice location 2

616 N Main Street
Andrews, TX 79706-3147
Phone (432) 505-4146

Other practice location 3

3490 East Yukon Rd
Odessa, TX 79762-2010
Phone (432) 520-4086

Other practice location 4

5514 N Big Spring Street
Midland, TX 79705-2697
Phone (432) 316-2441

Other practice location 5

6950 Eastridge Road
Odessa, TX 79765-8971
Phone (432) 505-4145

Other names 1

  • Miss Haley Diane Wilson 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181011002410 TX Practitioner - Physician Assistant 9638421068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Texas Tech University Health Science Center School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Providers PLLCGroup PAC ID 6002341021, 23 clinicians
Wes Tex Urgent Care PLLCGroup PAC ID 6305150863, 28 clinicians

Practice addresses (Care Compare)

3490 E Yukon Rd
Odessa, TX 79762-2010
Phone (432) 520-4086

4705 Briarwood Ave
Midland, TX 79707-2639
Phone (432) 618-5215

6950 Eastridge Rd
Odessa, TX 79765-8971
Phone (432) 366-0207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10201TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wes Tex Urgent Care, PLLC CurrentSince Oct 1, 2018 Accepting new patients
Gupta and Gupta Pediatrics MD PA Past Accepting new patients
Wes Tex Urgent Care, PLLC Past Accepting new patients

Locations

616 N Main St
Andrews, TX 79714
Phone (432) 375-5247

5514 N Big Spring St
Midland, TX 79705
Phone (432) 316-2441

6301 Andrews Hwy
Midland, TX 79706
Phone (432) 375-5247

4705 Briarwood Ave
Midland, TX 79707
Phone (432) 505-4145

210 W Longview Ave
Ste A
Midland, TX 79701
Phone (432) 789-1587

3490 E Yukon Rd
Odessa, TX 79762
Phone (432) 375-5247

6950 Eastridge Rd
Odessa, TX 79765
Phone (432) 366-0207

Interoperability endpoints

  • Direct secure messaging: haley.wilson.1@26958.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/16819/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1528430865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 BRIARWOOD AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797072639",
            "telephone_number": "325-054-1454",
            "fax_number": "833-941-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 BRIARWOOD AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797072639",
            "telephone_number": "325-054-1454",
            "fax_number": "833-941-0864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6301 Andrews Hwy",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "TX",
            "postal_code": "797063147",
            "country_code": "US",
            "telephone_number": "432-505-4147",
            "fax_number": "833-449-4803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "616 N Main Street",
            "address_purpose": "LOCATION",
            "city": "Andrews",
            "state": "TX",
            "postal_code": "797063147",
            "country_code": "US",
            "telephone_number": "432-505-4146",
            "fax_number": "866-450-0805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3490 East Yukon Rd",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "TX",
            "postal_code": "797622010",
            "country_code": "US",
            "telephone_number": "432-520-4086",
            "fax_number": "833-972-5449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5514 N Big Spring Street",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "TX",
            "postal_code": "797052697",
            "country_code": "US",
            "telephone_number": "432-316-2441",
            "fax_number": "833-428-1421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6950 Eastridge Road",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "TX",
            "postal_code": "797658971",
            "country_code": "US",
            "telephone_number": "432-505-4145",
            "fax_number": "833-941-0862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "HALEY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA10201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "WILSON",
            "middle_name": "DIANE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.