Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 200400283 | NC |
Y | 208600000X | Surgeon | 200400283 | NC |
N | 2086S0105X | Surgery of the Hand | 200400283 | NC |
NPI | 1780646760 |
---|---|
Provider Name | Barbara Jane Wilson |
First Address | Houston, TX 77030-2723 |
Second Address | Houston, TX 77030-2723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 13/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020001552 | (02) | VA |