Wilson, Diana Elizabeth

Wilson, Diana Elizabeth is an individual health care provider with primary practice located at 1325 Pennsylvania Ave Ste 890 , Fort Worth TX 76104-2145. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as her primary health care specialty. Wilson, Diana Elizabeth can be contacted via phone (817) 820-4280.

Contact Information

Primary practice address
1325 Pennsylvania Ave Ste 890 Fort Worth TX 76104-2145
Phone: (817) 820-4280
Fax: (817) 820-4281
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X J0729 Texas

Profile Details

NPI number 1538152400
LBN Legal business name Wilson, Diana Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2005
Last updated Jun 20th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538152400 NPPES
Texas MEDICAID 162405801
Texas MEDICAID 129595807

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