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General NPI Number Information
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NPI Number | 1538735329
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Entity Type | Individual
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Provider Name | CORY WILSON MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 18951 N MEMORIAL DR
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City | HUMBLE
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State | TX
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Zip | 77338-4217
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Country | US
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Telephone | 281-540-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 920 FROSTWOOD DR STE 2.300
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City | HOUSTON
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State | TX
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Zip | 77024-2314
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Country | US
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Telephone |
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R-12103
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | V6733
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | V6733
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD-51114
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | V6733
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License Number State | TX
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