Individual
KARRIEM WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6011 PORTICO DR APT 1835, FORT WORTH, TX 76132-4198
(318) 791-1496
Mailing address
6011 PORTICO DR APT 1835, FORT WORTH, TX 76132-4198
(318) 791-1496
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
982539
TX
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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