Individual
MS. TARA JENE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
9800 CENTRE PKWY, 530, HOUSTON, TX 77036-8271
(713) 777-4539
(713) 583-2061
Mailing address
9800 CENTRE PKWY, 530, HOUSTON, TX 77036-8271
(713) 777-4539
(713) 583-2061
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00516
TX
Other
Enumeration date
05/11/2010
Last updated
11/25/2014
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