Individual
MS. SUSAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-4060
Mailing address
4506 SHADYWOOD LN, COLLEYVILLE, TX 76034-4715
(817) 372-9347
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT83536
TX
Other
Enumeration date
11/25/2014
Last updated
12/02/2014
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