Provider Demographics
NPI:1053682989
Name:WHEAT, KAREN WILSON (OT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:WILSON
Last Name:WHEAT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S LOOP 250 W
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-2134
Mailing Address - Country:US
Mailing Address - Phone:432-689-2100
Mailing Address - Fax:
Practice Address - Street 1:808 TOWER DR
Practice Address - Street 2:SUITE 7
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761
Practice Address - Country:US
Practice Address - Phone:432-335-8777
Practice Address - Fax:432-335-8787
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110656225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist