Individual
MARINA LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-1475
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
79264
MT
208M00000X
Hospitalist Physician
Primary
T9871
TX
Other
Enumeration date
04/22/2013
Last updated
12/05/2022
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