Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Wildon Mellinger Rouse III

Individual provider Physician Assistant · NPI 1003873845

Mr. Wildon Mellinger Rouse III is a Physician Assistant in LA Grange, Texas. Qualified in 1999, 27 years ago. Practices with McBroom Clinic PA, an 8-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Texas.

Years since qualifying
27
Licensed in
TX
In the registry since
2006

Practice location Address checks out

1253 N Von Minden St
LA Grange, TX 78945-1262
Phone: (979) 968-8493
Fax: (979) 968-6388
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA02598 (TX)

Record details

NPI number1003873845
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 26, 2006
Last updated in NPPESDecember 4, 2013
Mailing address1253 N Von Minden St, La Grange, TX 78945-1262

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice McBroom Clinic Pa — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in LA Grange