Individual
CLIFFORD ELEAZER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
214 W ALHDAG AVENUE, WHARTON, TX 77488
(979) 282-2201
(979) 282-2202
Mailing address
214 W AHLDAG ST, WHARTON, TX 77488-2410
(979) 282-2201
(979) 282-2202
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19083
TX
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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