Search › Texas › 363A00000X
Destonee Wilson, PA-C
NPI 1174041578 · on the registry since 2017
Practice
- Address
- 1650 S Beach St
Fort Worth, TX 76105 - Phone
- (817) 702-1100
- Fax
- (817) 702-6124
- Clinicians at this address
- 12
Additional practice sites
- 2295 S Foothill Dr, Salt Lake City, UT
- 6360 S 3000 E Ste 100, Salt Lake City, UT
- 2295 S Foothill Dr, Salt Lake City, UT
- 13953 S Bangerter Pkwy, Draper, UT
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363A00000X
- Licence states on file
- UT, TX
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2018-11-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas