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Organization
JOHN W WILSON D O P A
Active
Organization
JOHN W WILSON D O P A
Active
Parent organization
JOHN W WILSON D O P A
Other names
JOHN W WILSON DO PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHN W WILSON D O P A
Authorized official
DR. JOHN W WILSON DO (PHYSICIAN)
(972) 889-1194
Entity
Organization
Contact information
Practice address
2011 N COLLINS BLVD, 609, RICHARDSON, TX 75080-2645
(972) 889-1194
(972) 889-1425
Mailing address
2011 N COLLINS BLVD, 609, RICHARDSON, TX 75080-2645
(972) 889-1194
(972) 889-1425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E6952
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195978501
—
TX
Enumeration date
06/14/2008
Last updated
11/13/2008
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