Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. CHARLES R WILSON, D.O.
Active Sole ProprietorDR. CHARLES R WILSON, D.O. is a Family Medicine healthcare provider located in SOUR LAKE, Texas. NPI 1790799807 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · SOUR LAKE, TX
Registration Details
- NPI Number
- 1790799807
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 27, 2006 (20.064469237512 yrs)
- Last Updated
- May 1, 2013
- License
-
H8516 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
327 MORRIS RD WSOUR LAKE, TX, 776599774Browse TX providers · Browse ZIP 77659
- Phone
- 4097532577
- Primary Specialty
-
Family Medicine
207Q00000X
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.