Individual
LINDA ORNELAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2315 W BEN WHITE BLVD, AUSTIN, TX 78704-7524
(512) 326-5440
(512) 326-8660
Mailing address
2315 W BEN WHITE BLVD, AUSTIN, TX 78704-7524
(512) 326-5440
(512) 326-8660
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G1253
TX
207L00000X
Anesthesiology Physician
G1253
TX
208VP0000X
Pain Medicine Physician
Primary
G1253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163138401
—
TX
01
—
8AT730
BLUE CROSS
TX
Enumeration date
06/06/2006
Last updated
09/26/2011
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