Individual
ALAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
6550 FANNIN ST, SUITE 1601, HOUSTON, TX 77030-2717
(713) 441-5141
Mailing address
6550 FANNIN ST, SUITE 1601, HOUSTON, TX 77030-2717
(713) 441-5141
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP128045
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352267401
—
TX
01
—
8045NV
BCBS
TX
01
—
8109NR
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/24/2015
Last updated
01/17/2017
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