Individual
DR. JENNIFER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
DEPARTMENT OF PEDIATRICS TTUHSC, 3601 4TH STREET, STOP 9406, LUBBOCK, TX 79430-0002
(806) 743-6630
Mailing address
2020 88TH ST, LUBBOCK, TX 79423-3438
(806) 782-6480
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
R6939
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10052519
TX
Other
Enumeration date
05/06/2015
Last updated
12/03/2021
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