Individual
WILSON LEWIS BEAVERSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 HILLCREST MEDICAL BLVD STE 304, WACO, TX 76712-8955
(254) 202-6580
(254) 754-6589
Mailing address
PO BOX 84891, DALLAS, TX 75284-8491
(254) 202-9330
(254) 202-9399
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA20089
TX
363AS0400X
Surgical Physician Assistant
Primary
—
TX
Other
Enumeration date
12/24/2025
Last updated
04/20/2026
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