Provider Demographics
NPI:1497716161
Name:WILHELMUS, DON A (OD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:A
Last Name:WILHELMUS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W SPRING CREEK PKWY
Mailing Address - Street 2:STE 103A
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4626
Mailing Address - Country:US
Mailing Address - Phone:972-424-5811
Mailing Address - Fax:972-881-1136
Practice Address - Street 1:305 W SPRING CREEK PKWY
Practice Address - Street 2:STE 103A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4626
Practice Address - Country:US
Practice Address - Phone:972-424-5811
Practice Address - Fax:972-881-1136
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3289TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT81939Medicare UPIN
TX00131PMedicare ID - Type UnspecifiedPROVIDER ID