Provider Demographics
NPI:1457543936
Name:WHELCHEL PRIMARY CARE MEDICINE PA
Entity Type:Organization
Organization Name:WHELCHEL PRIMARY CARE MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHELCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-935-7101
Mailing Address - Street 1:401 E PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-7207
Mailing Address - Country:US
Mailing Address - Phone:903-935-7101
Mailing Address - Fax:903-935-7043
Practice Address - Street 1:401 E PINECREST DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-7207
Practice Address - Country:US
Practice Address - Phone:903-935-7101
Practice Address - Fax:903-935-7043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00448ZMedicare PIN
TXH22428Medicare UPIN