Individual
DR. TOM W. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
4800 MEMORIAL DR, WACO, TX 76711-1329
(254) 297-3022
(254) 297-5378
Mailing address
4800 MEMORIAL DR, WACO, TX 76711-1329
(254) 297-3022
(254) 297-5378
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
19535
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19353
LICENSE NUMBER
TX
Enumeration date
08/13/2006
Last updated
07/08/2007
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