Individual
CORNELIUS A WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12739 WOODFOREST BLVD STE 2, HOUSTON, TX 77015-2737
(713) 450-4455
(713) 450-4737
Mailing address
PO BOX 24308, HOUSTON, TX 77229-4308
(713) 450-4455
(713) 450-4737
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J2845
TX
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
J2845
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137938013
—
TX
01
—
2242072
CIGNA
TX
01
—
87622Z
GLOBAL
TX
01
—
8AJ396
BLUE CROSS
TX
Enumeration date
09/13/2006
Last updated
03/09/2026
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