Active NPI
Patrick B Wilcox, DDS
- Pediatric Dentistry
- Edinburg, TX
National Provider Identifier
1003897257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 15114
- Practice address
- 2501 Cornerstone Blvd
Edinburg, TX 78539-8463 - Phone
- (956) 686-8611
- Fax
- (956) 686-2668
- NPI assigned
- Nov 7, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 15114 | TX | Primary |
Addresses
Primary practice location
2501 Cornerstone Blvd
Edinburg, TX 78539-8463
Mailing address
2501 Cornerstone Blvd
Edinburg, TX 78539-8463
Phone (956) 686-8611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120793801 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15114 | TX | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patrick B. Wilcox D.D.S, Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Edinburg, TX
- NPI 1225360191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398729600000",
"number": "1003897257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 CORNERSTONE BLVD",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785398463",
"telephone_number": "956-686-8611",
"fax_number": "956-686-2668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 CORNERSTONE BLVD",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785398463",
"telephone_number": "956-686-8611",
"fax_number": "956-686-2668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "PATRICK",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-07",
"last_updated": "2014-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "15114",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120793801",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edinburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.