Wilson, Jared

Wilson, Jared is an individual health care provider with primary practice located at 1150 E Eldorado Pkwy Ste 300 , Little Elm TX 75068-5504. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Sports Physician. Chiropractic Providers / Sports Physician is his primary health care specialty. Wilson, Jared can be contacted via phone (972) 292-9863.

Contact Information

Primary practice address
1150 E Eldorado Pkwy Ste 300 Little Elm TX 75068-5504
Fax: (972) 292-9861
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 3956 Oregon
Chiropractic Providers / Sports Physician 111NS0005X 3956 Oregon
Chiropractic Providers / Sports Physician 111NS0005X 15157 Texas

Profile Details

NPI number 1104059104
LBN Legal business name Wilson, Jared
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2009
Last updated Jul 25th, 2022 - about 2 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 1104059104 NPPES
Oregon MEDICAID 500707661

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