Individual
LISA M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2432 AVONDALE HASLET RD STE 200, HASLET, TX 76052-3428
(817) 993-2020
Mailing address
2432 AVONDALE HASLET RD STE 200, HASLET, TX 76052-3428
(817) 993-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13706
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11338TG
OPTOMETRIST
TX
Enumeration date
09/19/2005
Last updated
10/14/2025
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