MEDICARE: BARBARA JANE WILSON MD,FACS

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	208600000X	Surgery Physician	200400283	NC
2	2086S0105X	Surgery of the Hand (Surgery) Physician	200400283	NC

General Provider Information

NPI Number	:	1780646760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA JANE WILSON MD,FACS

Provider Business Mailing Address
First Line	:	6550 FANNIN ST
Second Line	:	SUITE 1723
City	:	HOUSTON
State	:	TX
Zip	:	77030-2723
Country	:	US
Telephone Number	:	832-530-4081
Fax Number	:	832-530-4082

Provider Business Practice Location Address
First Line	:	6550 FANNIN ST
Second Line	:	SUITE 1723
City	:	HOUSTON
State	:	TX
Zip	:	77030-2723
Country	:	US
Telephone Number	:	832-530-4081
Fax Number	:	832-530-4082

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	01/13/2016

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