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DR. LEE ROY WIEDERHOLD MD PHD NPI 1134323736


NPI Information

NPI: 1134323736
Provider Name: DR. LEE ROY WIEDERHOLD, MD, PHD
Classification: Radiology - 2085R0001X
Entity Type: Individual

Specialization: Radiation Oncology

Organization: PHYSICIANS REFERRAL SERVICE

PECOS Registration: Yes

Address:
301 UNIVERSITY BLVD
GALVESTON, TX
ZIP 77555
Phone: (409) 772-2531
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DR. Lee Roy Wiederhold, MD, PHD is a radiation oncology radiology in Galveston, TX with 19 years of experience. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. DR. Lee Roy Wiederhold, MD, PHD NPI is 1134323736. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduation Year:2005

The provider's business location address is:

301 UNIVERSITY BLVD
GALVESTON, TX
ZIP 77555-462
Phone: (409) 772-2531
Fax: (409) 772-1814

The NPI 1134323736 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Calculation of radiation therapy dose (HCPCS:77300)
  • Radiation treatment management, 5 treatments (HCPCS:77427)
  • Radiation treatment devices, design and construction, complex (HCPCS:77334)
  • Management of radiation therapy, simulation, complex (HCPCS:77290)
  • Management of radiation therapy, complex (HCPCS:77263)
  • Diagnostic examination of voice box using flexible endoscope (HCPCS:31575)

The enumeration date for this NPI number is 6/14/2007 and was last updated on 1/29/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0001XRadiologyRadiation OncologyM5976TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13847415682OTHERMYUTMB 3847415682-COMMERCIAL NUMBER
2213444703OTHERTEXASMEDICAID CSHCN
3213444702MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.