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Individual

MR. MARK L WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
601 E 15TH ST, AUSTIN, TX 78701-1930
(512) 324-7000
Mailing address
4311 SINCLAIR AVE, AUSTIN, TX 78756-3218

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
249657
TX

Other

Enumeration date
04/18/2006
Last updated
02/25/2015
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