Individual
JANIS PAYNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5820 CLEAR CREEK DR, HALTOM CITY, TX 76137-5802
(817) 456-4484
Mailing address
5820 CLEAR CREEK DR, HALTOM CITY, TX 76137-5802
(817) 456-4484
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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