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General NPI Number Information
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NPI Number | 1588673057
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Entity Type | Individual
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Provider Name | FRANK PATRICK WILSON JR. D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 2710 HOSPITAL DR SUITE 110
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City | VICTORIA
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State | TX
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Zip | 77901-5701
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Country | US
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Telephone | 361-578-0317
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3610
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City | VICTORIA
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State | TX
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Zip | 77903-3610
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Country | US
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Telephone | 361-578-0317
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | F3384
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License Number State | TX
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