Individual
DR. DAVID B WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 PENNSYLVANIA AVE, SUITE 560, FORT WORTH, TX 76104-2158
(817) 820-2890
Mailing address
1325 PENNSYLVANIA AVE, SUITE 560, FORT WORTH, TX 76104-2158
(817) 820-2890
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
F8735
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045BY
BCBS TEXAS/ MEDICARE GROUP #
TX
05
—
080636601
—
TX
05
—
130380205
—
TX
01
—
88822F
BCBS TEXAS/ MEDICARE INDIVIDUAL #
TX
Enumeration date
07/07/2006
Last updated
01/20/2015
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