Individual
GOLDER N. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 4TH ST, MS 9406, LUBBOCK, TX 79430-0002
(806) 743-7337
(806) 743-7329
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
H5095
TX
208000000X
Pediatrics Physician
H5095
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100056830 A
—
OK
05
—
119194204
—
TX
05
—
119194205
—
TX
05
—
119194211
—
TX
05
—
119194212
—
TX
05
—
119194216
—
TX
01
—
127048101
FIRSTCARE COMMERCIAL
TX
05
—
127048102
—
TX
05
—
31405762
—
NM
01
—
82994
PRESBYTERIAN COMMERCIAL
NM
05
—
82994
—
NM
01
—
87286Z
HMO BLUE
TX
01
—
8H8760
BC/BS
TX
01
—
A562
TRIWEST
NM
01
—
Y0069496
DPS
TX
Enumeration date
10/24/2005
Last updated
03/07/2023
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