# MR. JOHN ROBERT WILSON JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1497178941
- **Gender:** Man
- **Credential:** R.PH.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1835P0018X | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 34911 | TX | Yes |

## Other

- **Enumeration date:** 02/03/2014
- **Last updated:** 02/03/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 34911 | TEXAS STATE BOARD OF PHARMACY LICENSE | TX |