1760158273 NPI number — WHEEL MEDICAL OF WASHINGTON, P.C.

Table of content: ROBERT JOHN SOZA RODRIGUEZ (NPI 1679322812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760158273 NPI number — WHEEL MEDICAL OF WASHINGTON, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHEEL MEDICAL OF WASHINGTON, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760158273
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2330 S LAMAR BLVD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-850-5498
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2330 S LAMAR BLVD.
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-850-5498
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/17/2021

Additional Information

Authorized Official

Authorized Official Last Name:
DAVEY
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
512-657-1089

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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