MEDICARE: CAITLIN J WILSON PHARM.D.

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	1835P2201X	Ambulatory Care Pharmacist	55836	TX
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	55836	TX

General Provider Information

NPI Number	:	1831539840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN J WILSON PHARM.D.

Provider Business Mailing Address
First Line	:	1504 TAUB LOOP
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1712 E 1ST ST STE M20
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-5238
Country	:	US
Telephone Number	:	281-446-4139
Fax Number	:	281-446-4860

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

Provider Enumeration Date	:	07/05/2013
Last Update Date	:	11/25/2025

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