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NPI Code Detail

MEDICARE: JAMES W WILSON D.D.S.

MEDICARE:   JAMES W WILSON  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223S0112XOral and Maxillofacial Surgery (Dentist)10950TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
185D510OTHERTXBCBS

General Provider Information

NPI Number : 1184654527
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES W WILSON D.D.S.
Provider Business Mailing Address
First Line : PO BOX 201088
Second Line :
City : HOUSTON
State : TX
Zip : 77216-1088
Country : US
Telephone Number : 713-500-3500
Fax Number :
Provider Business Practice Location Address
First Line : 6550 FANNIN ST
Second Line : 2237
City : HOUSTON
State : TX
Zip : 77030-2717
Country : US
Telephone Number : 713-790-4600
Fax Number : 713-793-1229
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 02/12/2008

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Directions to “ JAMES W WILSON D.D.S.” Practice Location

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