Wilson, Katie Lynn
Wilson, Katie Lynn is an sole proprietor health care provider with primary practice located at 100 E Ferguson St Ste 1204 , Tyler TX 75702-5700. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Wilson, Katie Lynn can be contacted via phone (903) 509-2040.Contact Information
Primary practice address
100 E Ferguson St Ste 1204
Tyler TX 75702-5700
Phone: (903) 509-2040
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | 1232246 | Texas |
Profile Details
| NPI number | 1972980779 |
|---|---|
| LBN Legal business name | Wilson, Katie Lynn |
| Credentials | PT, DPT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 30th, 2015 |
| Last updated | Mar 4th, 2018 - about 7 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 | 1972980779 | NPPES |
| Texas | MEDICAID | 1972980779 |
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