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Individual
DR. RICHARD ALLEN WILSON
Active
Individual
DR. RICHARD ALLEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
26065
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223G0001X
DENTIST-GENERAL PRACTICE
TX
05
—
1223G0001X
—
TX
Enumeration date
10/07/2008
Last updated
02/16/2017
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