Individual
MR. BRUCE MICHAEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1405 W JEFFERSON ST, WAXAHACHIE, TX 75165-2231
(972) 937-7240
(972) 937-4255
Mailing address
800 N HIGHWAY 77, STE 160 PMB#224, WAXAHACHIE, TX 75165-1884
(972) 937-7240
(972) 937-4255
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
253451
TX
Other
Enumeration date
12/29/2005
Last updated
07/09/2007
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