Individual
MR. JOHN ROBERT WILSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1206 W CAMPUS DR, TEMPLE, TX 76502-7124
(254) 298-6144
Mailing address
1206 W CAMPUS DR, TEMPLE, TX 76502-7124
(254) 298-6144
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
34911
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34911
TEXAS STATE BOARD OF PHARMACY LICENSE
TX
Enumeration date
02/03/2014
Last updated
02/03/2014
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