Provider Demographics
NPI:1760909295
Name:WHEELER, CLAYTON (AUDIOLOGY)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:
Last Name:WHEELER
Suffix:
Gender:M
Credentials:AUDIOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5269
Mailing Address - Country:US
Mailing Address - Phone:325-437-4730
Mailing Address - Fax:
Practice Address - Street 1:7 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5269
Practice Address - Country:US
Practice Address - Phone:325-437-4730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81004231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1235676529OtherRENDERING NPI