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General NPI Number Information
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NPI Number | 1801889993
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Entity Type | Organization
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Legal Business Name | MIDLAND EMERGENCY MANAGEMENT PLLC
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 2200 W ILLINOIS AVE
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City | MIDLAND
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State | TX
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Zip | 79701-6407
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Country | US
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Telephone | 432-685-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 9301 S WESTERN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-2767
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Country | US
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Telephone | 866-321-8433
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAWRENCE WILSON
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Credential | MD
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Telephone | 432-685-1558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | TX
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