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STEPHEN L WILSON MD PA NPI 1669653499


NPI Information

NPI: 1669653499
Provider Name: STEPHEN L WILSON MD PA

Doing Business As: WESTERN MEDICAL CENTER

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1015 S HENDERSON ST
FORT WORTH, TX
ZIP 76104
Phone: (817) 870-1035
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STEPHEN L WILSON MD PA is a specialist in Fort Worth, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. STEPHEN L WILSON MD PA NPI is 1669653499. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Western Medical Center.

The provider's business location address is:

1015 S HENDERSON ST
FORT WORTH, TX
ZIP 76104-924
Phone: (817) 870-1035
Fax: (817) 332-5005

The provider's authorized official is Priscilla Porras .
The authorized official title is Administrator and has the following contact phone number (817) 870-1035.

The enumeration date for this NPI number is 11/20/2007 and was last updated on 2/11/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistTEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100737NMEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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