Wildon Mellinger Rouse

Physician assistant in La Grange, Texas · NPI 1003873845

Wildon Rouse is one of 7 physician assistants practicing in La Grange, Texas. Wildon Rouse practices with McBroom Clinic PA.

Registry record (NPPES)

NPI
1003873845
Type
Type 1 · Individual
Primary taxonomy
Physician Assistant · 363A00000X
Address on file
1253 N Von Minden St
La Grange, TX 78945-1262
(979) 968-8493
Enumerated
Apr 26, 2006
Record last updated
Dec 4, 2013
License states listed
TX

Medicare (CMS)

Enrollment
Medicare-enrolled in TX
Physician Assistant
Revalidation due
No date set by CMS

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  • Procedure volumes by CPT code
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  • Full enrollment history
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Practice locations

More physician assistants in La Grange

Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.