MEDICARE: WYTEKA 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	183500000X	Pharmacist	36417	TX

General Provider Information

NPI Number	:	1326476680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WYTEKA WILSON

Provider Business Mailing Address
First Line	:	111 S WILLIAM BARNETT AVE
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4541
Country	:	US
Telephone Number	:	281-593-3800
Fax Number	:	281-593-2928

Provider Business Practice Location Address
First Line	:	111 S WILLIAM BARNETT AVE
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4541
Country	:	US
Telephone Number	:	281-593-3800
Fax Number	:	281-593-2928

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

Provider Enumeration Date	:	10/24/2013
Last Update Date	:	06/29/2026

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Directions to “ WYTEKA WILSON ” Practice Location

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