Provider Demographics
NPI:1396777355
Name:AUGUSTIN-WHEELER, ROSIE (MD)
Entity type:Individual
Prefix:DR
First Name:ROSIE
Middle Name:
Last Name:AUGUSTIN-WHEELER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSIE
Other - Middle Name:
Other - Last Name:AUGUSTIN-WHEELER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1735 UNION ST STE A
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-1201
Mailing Address - Country:US
Mailing Address - Phone:512-986-8858
Mailing Address - Fax:512-986-8853
Practice Address - Street 1:1735 UNION ST STE A
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-1201
Practice Address - Country:US
Practice Address - Phone:512-986-8858
Practice Address - Fax:512-986-8853
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1984208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX288238302Medicaid