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:
Health care specialties
Specialty | Code | License # | 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 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1538152400 | NPPES |
Texas | MEDICAID | 162405801 | |
Texas | MEDICAID | 129595807 |
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