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General NPI Number Information
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NPI Number | 1053533828
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Entity Type | Individual
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Provider Name | KARLA A WILD M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3719 NATHANIEL SPRINGS DR
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City | MANVEL
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State | TX
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Zip | 77578-2739
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Country | US
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Telephone | 281-489-1789
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Fax | 281-489-7796
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Provider Business Mailing Address
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Address Line | 3719 NATHANIEL SPRINGS DR
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City | MANVEL
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State | TX
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Zip | 77578-2739
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Country | US
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Telephone | 281-489-1789
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Fax | 281-489-7796
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | H8511
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License Number State | TX
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