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Individual

ALMA R. WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHCNP

Contact information

Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-5306
(214) 590-2798
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
574217
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
163720901
TX
05
163720902
TX
05
163720903
TX
05
163720904
TX
05
163720905
TX
05
163720906
TX
05
163720907
TX
05
163720908
TX
05
163720909
TX
05
163720911
TX
01
8N4779
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/28/2005
Last updated
06/23/2009
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