Active NPI
Brandon O'Neill Wielert, DPT
- Physical Therapist
- Jbsa Lackland, TX
National Provider Identifier
1629418124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT4468
- Practice address
- 1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638 - Phone
- (660) 909-2494
- NPI assigned
- Jun 28, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4468 | NM | Primary |
Addresses
Primary practice location
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Mailing address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT4468 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Linda Munro Psy D PA | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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": "1372377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748563200000",
"number": "1629418124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP BLDG 4554",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP BLDG 4554",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "660-909-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIELERT",
"first_name": "BRANDON",
"middle_name": "O'NEILL",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-28",
"last_updated": "2025-05-30",
"certification_date": "2025-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "NM",
"license": "PT4468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.