MEDICARE: HEATHER WILSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	71954	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71954	OTHER	TX	LICENSED PROFESSIONAL COUNSELOR, INTERN

General Provider Information

NPI Number	:	1154689180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER WILSON

Provider Business Mailing Address
First Line	:	5817 HILLCREST AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-2260
Country	:	US
Telephone Number	:	214-526-8986
Fax Number	:

Provider Business Practice Location Address
First Line	:	5817 HILLCREST AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-2260
Country	:	US
Telephone Number	:	214-526-8986
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2012
Last Update Date	:	10/22/2015

Similar Medicare Providers

1730235896 — LUXOTTICA OF AMERICA INC.
Practice Location Address:

13350 DALLAS PKWY STE 2260
DALLAS, TX
75240-6649

Practice Phone: 972-458-7070
Practice Fax:

1114103686 — MS. CHRISTINE J. MEZZA LPC
Practice Location Address:

2260 GOLD MINE RD
DALLAS, GA
30157

Practice Phone: 678-978-0464
Practice Fax: 770-505-3190

1124508189 — MRS. ANN WANGARI KARANJA
Practice Location Address:

12516 AUDELIA RD APT 1404
DALLAS, TX
75243-2260

Practice Phone: 423-579-4909
Practice Fax:

1275004509 — MK PHARMACY SERVICES LLC
Practice Location Address:

932 W DALLAS ST STE C
CONROE, TX
77301-2260

Practice Phone: 832-703-0067
Practice Fax:

1326645276 — FRAZIER PHARMACY LLC
Practice Location Address:

932 W DALLAS ST STE E
CONROE, TX
77301-2260

Practice Phone: 281-377-0685
Practice Fax:

1417164054 — DR. MATTHEW YOCOM D.C.
Practice Location Address:

4245 N CENTRAL EXPY STE 245
DALLAS, TX
75205-4569

Practice Phone: 800-404-6050
Practice Fax: 866-313-3397

Directions to “ HEATHER WILSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.