Individual
SHARON WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LO
Contact information
Practice address
801 S HARRISON ST, WEST, TX 76691-1727
(254) 826-5178
Mailing address
PO BOX 262, WEST, TX 76691-0262
(254) 826-5178
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
342
TX
Other
Enumeration date
11/16/2009
Last updated
11/16/2009
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