Individual
JOHN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
Mailing address
403 FOSTER LN, CANYON, TX 79015-4229
(806) 679-8720
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
D0096296
MD
2084P0800X
Psychiatry Physician
Primary
T3569
TX
Other
Enumeration date
04/17/2019
Last updated
08/27/2024
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