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Individual

DR. PAMELA DOYLENE WILSON

Active
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Individual

DR. PAMELA DOYLENE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
J8842
TX
207L00000X
Anesthesiology Physician
Primary
J8842
TX
208VP0014X
Interventional Pain Medicine Physician
J8842
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8AH490
BLUE CROSS BLUE SHIELD TEXAS
TX
Enumeration date
10/13/2005
Last updated
09/27/2018
Update your record

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