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1194827337

NPI Code Detail

MEDICARE: MR. JAMES WILSON MD

MEDICARE: MR. JAMES WILSON MD

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	207RI0011X	Interventional Cardiology Physician	J5062	TX
2	207RC0000X	Cardiovascular Disease Physician	J5062	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060042185	OTHER	TX	MCR RAILROAD
2	82500F	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5907011	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1194827337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES WILSON MD

Provider Business Mailing Address
First Line	:	1701 SUNSET BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1798
Country	:	US
Telephone Number	:	713-520-4713
Fax Number	:	713-520-4755

Provider Business Practice Location Address
First Line	:	1701 SUNSET BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1798
Country	:	US
Telephone Number	:	713-526-5511
Fax Number	:

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	06/24/2024

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Directions to “ MR. JAMES WILSON MD” Practice Location

Language	Start Address	Practice Location

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