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General NPI Number Information
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NPI Number | 1831212729
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Entity Type | Individual
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Provider Name | WARREN WINSLOW WILSON DC
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Gender | Male
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Dates
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Enumeration Date | 04/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 506 LIMESTONE DR
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City | EULESS
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State | TX
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Zip | 76039-3617
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Country | US
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Telephone | 817-368-4400
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Fax | 817-545-5260
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Provider Business Mailing Address
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Address Line | 506 LIMESTONE DR
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City | EULESS
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State | TX
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Zip | 76039-3617
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Country | US
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Telephone | 817-368-4400
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Fax | 817-545-5260
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 9222
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License Number State | TX
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