# WILSON DURABLE MEDICAL EQUIPMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417221102
- **Authorized official:** MICHELLE ELLEN WILSON (OWNER)
- **Authorized official phone:** (469) 323-5474

## Contact information

- **Practice address:** 2806 JESSICA LANE, LUCAS, TX 75002
- **Practice address phone:** (469) 323-5474
- **Mailing address:** 2806 JESSICA LN, LUCAS, TX 75002-3703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | TX | Yes |

## Other

- **Enumeration date:** 02/28/2012
- **Last updated:** 02/28/2012