Organization
STEPHEN L WILSON MD PA
Active
Other names
Western Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PRISCILLA PORRAS (ADMINISTRATOR)
(817) 870-1035
Entity
Organization
Contact information
Practice address
1015 S HENDERSON ST, FORT WORTH, TX 76104-2924
(817) 870-1035
(817) 332-5005
Mailing address
1015 S HENDERSON ST, FORT WORTH, TX 76104-2924
(817) 870-1035
(817) 332-5005
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
TX
Other
Enumeration date
11/20/2007
Last updated
02/11/2008
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