Individual
DR. PATRICE SUZANNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-9374
(214) 648-5461
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
55834
MN
207L00000X
Anesthesiology Physician
Primary
Q8188
TX
207LP3000X
Pediatric Anesthesiology Physician
Q8188
TX
207R00000X
Internal Medicine Physician
BP10041734
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2011
Last updated
09/22/2016
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