Organization
JAMES L WILDER MD PA
Active
Other names
South Texas Gynecologic Oncology
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LOWELL WILDER MD (OWNER)
(210) 402-3700
Entity
Organization
Contact information
Practice address
540 MADISON OAK DR, STE #570, SAN ANTONIO, TX 78258-3943
(210) 402-3700
(210) 402-3892
Mailing address
540 MADISON OAK DR, STE #570, SAN ANTONIO, TX 78258-3943
(210) 402-3700
(210) 402-3892
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0073MQ
BCBS PIN
TX
Enumeration date
10/19/2007
Last updated
10/19/2007
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