Provider Demographics
NPI:1861660300
Name:VALERIE WHEELOCK, M.D., P.A.
Entity Type:Organization
Organization Name:VALERIE WHEELOCK, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-327-0562
Mailing Address - Street 1:7004 BEE CAVE RD
Mailing Address - Street 2:BLDG 1, SUITE 210
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5004
Mailing Address - Country:US
Mailing Address - Phone:512-327-0562
Mailing Address - Fax:512-327-8219
Practice Address - Street 1:7004 BEE CAVE RD
Practice Address - Street 2:BLDG 1, SUITE 210
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5004
Practice Address - Country:US
Practice Address - Phone:512-327-0562
Practice Address - Fax:512-327-8219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4651208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty