Individual
HAILEY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6410 FANNIN ST STE 210, HOUSTON, TX 77030-3004
(832) 325-7288
Mailing address
6431 FANNIN ST # 3.286, HOUSTON, TX 77030-1501
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
714785
TX
363A00000X
Physician Assistant
Primary
PA14003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA14003
TEXAS MEDICAL BOARD
TX
Enumeration date
10/02/2020
Last updated
09/02/2025
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