Provider Demographics
NPI:1578754883
Name:WHEELER, NOLAN JAY (DC)
Entity Type:Individual
Prefix:
First Name:NOLAN
Middle Name:JAY
Last Name:WHEELER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 LOUETTA RD
Mailing Address - Street 2:STE 118
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4351
Mailing Address - Country:US
Mailing Address - Phone:281-355-1838
Mailing Address - Fax:281-528-7441
Practice Address - Street 1:4711 LOUETTA RD
Practice Address - Street 2:STE 118
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4351
Practice Address - Country:US
Practice Address - Phone:281-355-1838
Practice Address - Fax:281-528-7441
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9897111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M1551OtherBCBS
TX8M1551OtherBCBS