Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LARRY DON WILSON, PA-C
Active Sole ProprietorLARRY DON WILSON, PA-C is a Medical Physician Assistant healthcare provider located in BACLIFF, Texas. NPI 1306848981 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · BACLIFF, TX
Registration Details
- NPI Number
- 1306848981
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 12, 2005 (20.998285741922 yrs)
- Last Updated
- Dec 21, 2010
- License
-
PA00742 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1136 GRAND AVEBACLIFF, TX, 775182760Browse TX providers · Browse ZIP 77518
- Phone
- 2813395018
- Fax
- 2813395098
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.