MEDICARE: GEORGE WILCOX DO

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	208M00000X	Hospitalist Physician	J6806	TX
2	207R00000X	Internal Medicine Physician	J6806	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609973650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE WILCOX DO

Provider Business Mailing Address
First Line	:	12446 WEST AVE
Second Line	:	STE 200
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-2530
Country	:	US
Telephone Number	:	210-525-1668
Fax Number	:	210-525-1669

Provider Business Practice Location Address
First Line	:	16620 N US HIGHWAY 281 STE 300
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-2679
Country	:	US
Telephone Number	:	210-309-1405
Fax Number	:	210-688-4596

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/16/2019

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Directions to “ GEORGE WILCOX DO” Practice Location

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