Individual
SHAKIRA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3611 ENNIS ST, HOUSTON, TX 77004-4407
(832) 393-4062
(832) 393-4068
Mailing address
1255 N POST OAK RD APT 2202, HOUSTON, TX 77055-7336
(832) 836-1748
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
9762
TX
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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