Individual
LANCE A. WILKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4916 OVERTON PLZ, FORT WORTH, TX 76109-4415
(817) 334-0530
(817) 877-0350
Mailing address
4916 OVERTON PLZ, FORT WORTH, TX 76109-4415
(817) 334-0530
(817) 877-0350
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
698485
TX
Other
Enumeration date
11/07/2007
Last updated
10/12/2009
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