Wilson, Randall G

Wilson, Randall G is an individual health care provider with primary practice located at 3430 W Wheatland Rd Suite 202, Dallas TX 75237-3446. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Cardiology. Allopathic & Osteopathic Physicians / Nuclear Cardiology is his primary health care specialty. Wilson, Randall G can be contacted via phone (972) 296-7920.

Contact Information

Primary practice address
3430 W Wheatland Rd Suite 202 Dallas TX 75237-3446
Phone: (972) 296-7920
Fax: (972) 296-7938
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X G7961 Texas
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X G7961 Texas

Profile Details

NPI number 1144279407
LBN Legal business name Wilson, Randall G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2006
Last updated May 17th, 2013 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144279407 NPPES
Texas Other 8C0880 BCBS
Texas MEDICAID 148882701 BCBS

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