Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 129596 | TX |
NPI | 1023109295 |
---|---|
Provider Name | Richard F Wilks |
First Address | San Antonio, TX 78217 |
Second Address | San Antonio, TX 78217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G03034 | (02) | TX |