Individual
JESSICA L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PSGT
Contact information
Practice address
251 E SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-6269
(817) 424-0971
(888) 866-4929
Mailing address
251 E SOUTHLAKE BLVD, SUITE 150, SOUTHLAKE, TX 76092-6269
(817) 424-0971
(888) 866-4929
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
5193
TX
Other
Enumeration date
03/15/2007
Last updated
01/20/2017
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