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Organization
HUGH H WILSON JR, M.D., P. A.
Active
Organization
HUGH H WILSON JR, M.D., P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUGH H WILSON JR. M.D. (PHYSICIAN)
(806) 687-5754
Entity
Organization
Contact information
Practice address
1600 S SUNSET AVE, LITTLEFIELD, TX 79339-4810
(806) 385-6424
(806) 385-4305
Mailing address
10502 GARY AVE, LUBBOCK, TX 79423-6047
(806) 687-5754
(806) 385-4305
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D6212
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005KP
BLUE CROSS BLUE SHIELD GROUP
TX
05
—
110413510
—
TX
05
—
110413512
—
TX
05
—
110413513
—
TX
01
—
8K1510
BLUE CROSS BLUE SHIELD INDIVIDUAL
TX
Enumeration date
04/13/2011
Last updated
11/21/2011
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