Individual
ALEXANDER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
5759 EAGLES NEST BLVD STE 4, TYLER, TX 75703-6231
(903) 405-4899
(903) 638-2741
Mailing address
1731 MCDONALD RD, TYLER, TX 75701-4724
(903) 274-9977
(903) 638-2741
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1407082
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407082
STATE LICENSE NUMBER
TX
Enumeration date
08/15/2025
Last updated
08/15/2025
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