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General NPI Number Information
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NPI Number | 1346297694
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Entity Type | Individual
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Provider Name | SELMA P WILSON MD
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Gender | Female
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 4102 24TH ST SUITE 409
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City | LUBBOCK
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State | TX
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Zip | 79410-1806
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Country | US
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Telephone | 806-796-7246
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Fax | 806-791-1462
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Provider Business Mailing Address
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Address Line | PO 93117
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City | LUBBOCK
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State | TX
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Zip | 79493
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Country | US
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Telephone | 806-796-7246
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Fax | 806-791-1462
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | H7850
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License Number State | TX
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