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NPI Code Detail

MEDICARE: ROBERT WILSON DO

MEDICARE: ROBERT WILSON DO
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
1207Q00000XFamily Medicine PhysicianU5265TX

General Provider Information

NPI Number : 1538783832
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT WILSON DO
Provider Business Mailing Address
First Line : 2700 W PECAN ST STE 102
Second Line :
City : PFLUGERVILLE
State : TX
Zip : 78660-3069
Country : US
Telephone Number : 512-421-3750
Fax Number : 512-421-3750
Provider Business Practice Location Address
First Line : 2700 W PECAN ST STE 102
Second Line :
City : PFLUGERVILLE
State : TX
Zip : 78660-3069
Country : US
Telephone Number : 512-421-3750
Fax Number : 512-421-3750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2020
Last Update Date : 10/24/2024

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Directions to “ ROBERT WILSON DO” Practice Location

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