Individual
MATTHEW L WILNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8230 WALNUT HILL LN, SUITE 700, DALLAS, TX 75231-4482
(214) 691-1902
(214) 987-1845
Mailing address
3600 GASTON AVE, SUITE 1205, DALLAS, TX 75246-1800
(214) 692-8262
(214) 696-4190
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
H8893
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103838201
—
TX
01
—
340016197
RRMCR
TX
01
—
80404X
BCBS PROVIDER ID
—
Enumeration date
05/20/2006
Last updated
01/31/2017
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