Individual
DAVID WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1050 E. HWY. 114, SUITE 100, SOUTHLAKE, TX 76092-4917
(817) 329-8364
(817) 329-1285
Mailing address
1050 E. HWY. 114, SUITE 100, SOUTHLAKE, TX 76092-4917
(817) 329-8364
(817) 329-1285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R0813
TX
Other
Enumeration date
04/22/2014
Last updated
09/22/2021
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