Individual
DR. DARRELL WALLACE WILCOX
Active
Individual
DR. DARRELL WALLACE WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
P3485
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10035402-ID#540187
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324224001
—
TX
05
—
324224002
—
TX
01
—
8DY159
BLUE CROSS BLUE SHIELD
TX
01
—
P01237859
RAILROAD MEDICARE
TX
Enumeration date
08/10/2009
Last updated
05/07/2020
Update your record
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