Look up the most recent NPI and PECOS records

Michael Joe Whiteley

Family Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as MICHAEL WHITELEY.

Based on the most recent information from CMS, provider Michael Joe Whiteley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1295720795
Provider Type
Individual
Full Name
Whiteley, Michael Joe
Credential
D.O.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
9/12/2005
Last Updated
3/7/2023

Contact Information

Practice Location

29214 Quinn Rd, Tomball, TX 77375-4486

(281) 351-4208

(281) 351-5417

Mailing Location

29214 Quinn Rd, Tomball, TX 77375-4486

(281) 351-4208

(281) 351-5417

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License F2109 Texas

Provider Identifiers

ID	Description	Issuer
ID 45DO8899310	Description Other	Issuer CLIA # Texas
ID 0718145	Description Other	Issuer NAIS # Texas
ID 032573001	Description Medicaid	Issuer Unlisted Texas
ID F2109	Description Other	Issuer STATE LICENSE Texas
ID H0048255	Description Other	Issuer DPS # Texas

Michael Joe Whiteley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer