Individual
MARC WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 857-0734
Mailing address
1420 ALTA MESA CT, MESQUITE, TX 75150-6821
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
685458
TX
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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