Active NPI
Kendal Phillip Wilson, KENDAL WILSON M.D.
- Physical Medicine & Rehabilitation Physician
- Bedford, TX
National Provider Identifier
1043235054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- H7256
- Practice address
- 1600 Hospital Pkwy
Bedford, TX 76022-6913 - Phone
- (817) 685-4920
- NPI assigned
- Jul 12, 2006
- Last updated
- May 19, 2008
- 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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | H7256 | TX | Primary |
Addresses
Primary practice location
1600 Hospital Pkwy
Bedford, TX 76022-6913
Mailing address
313 Waterside Dr
Irving, TX 75063-4252
Phone (972) 444-0907
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H7256 | TX | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1043235054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 WATERSIDE DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750634252",
"telephone_number": "972-444-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 HOSPITAL PKWY",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760226913",
"telephone_number": "817-685-4920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KENDAL",
"middle_name": "PHILLIP",
"name_prefix": "Dr.",
"credential": "KENDAL WILSON M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "TX",
"license": "H7256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, TX
- Shanedah Williams
- Linda Teal Willoughby, PHD LPC
- Chris Willsey
- Courtney Marie Wilson, RD, LD, CDCES
- Jamie Sueann Wilson, LMT
- Pat Wimmer, MD
- Hannah Marie Winn, D.C., EMT-B
- Winnie-Stowell Hospital District (Forum Parkway Health & Rehabilitation)
- Winnie-Stowell Hospital District (Forum Parkway Health & Rehabilitation)
- Jeron Phillip Winslow, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.