Individual provider Active NPI

Harlan P Wichelhaus, M.D.

  • Obstetrics & Gynecology Physician
  • Texas City, TX
National Provider Identifier
1649459769
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
J0727 Issued in TX
Practice address
1718 North Amburn Rd.
Suite B
Texas City, TX 77591-2490
Phone
(409) 935-1988
Fax
(409) 933-4898
NPI assigned
Oct 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X J0727 TX Primary

Addresses

Primary practice location

1718 North Amburn Rd.
Suite B
Texas City, TX 77591-2490

Mailing address

1718 North Amburn Rd.
Suite B
Texas City, TX 77591-2490
Phone (409) 935-1988

Other identifiers 1

IdentifierTypeStateIssuer
096391004MedicaidTX

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
I20040810001212 TX Practitioner - Obstetrics/Gynecology 5193797108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wake Forest University School of Medicine, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1718 N Amburn Rd
Suite B
Texas City, TX 77591-2490
Phone (409) 935-1988

Hospital & facility affiliations

  • HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617
  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harlan Wichelhaus, MD, PA CurrentSince Oct 19, 2004 Accepting new patients
Utmb Faculty Group Practice Obstetrics & Gynecology Past Accepting new patients

Locations

1125 Highway 3 N
Ste 130
Texas City, TX 77591
Phone (409) 935-1988

1718 N Amburn Rd
Ste B
Texas City, TX 77591
Phone (409) 908-0452

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1649459769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 NORTH AMBURN RD.",
            "address_2": "SUITE B",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775912490",
            "telephone_number": "409-935-1988",
            "fax_number": "409-933-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 NORTH AMBURN RD.",
            "address_2": "SUITE B",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775912490",
            "telephone_number": "409-935-1988",
            "fax_number": "409-933-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHELHAUS",
        "first_name": "HARLAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-25",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J0727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096391004",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texas City, TX

Sources for this page

Verify at the official NPI Registry.