Individual
DR. JONATHAN WILKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, UNIT 409, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
P6298
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323830501
—
TX
01
—
8DY717
BCBS
TX
Enumeration date
03/09/2010
Last updated
01/17/2014
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