Individual
BEVERLY JOAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
8153 HONEYGO BLVD STE C, BALTIMORE, MD 21236-8206
(443) 678-4141
(443) 678-1276
Mailing address
11103 WEST AVE, SUITE 6, SAN ANTONIO, TX 78213-1370
(210) 524-6509
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
DA1866
MD
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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