Individual provider Active NPI

Mark P Wilson, FNP

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1043467145
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP116948 Issued in TX
Practice address
11555 Culebra Rd Lot 84
San Antonio, TX 78253-4826
Phone
(210) 379-0501
NPI assigned
Aug 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 648078 TX
Family Nurse Practitioner 363LF0000X AP116948 TX Primary

Addresses

Primary practice location

11555 Culebra Rd Lot 84
San Antonio, TX 78253-4826

Mailing address

11555 Culebra Rd Lot 84
San Antonio, TX 78253-4826
Phone (210) 379-0501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110602000007 TX Practitioner - Nurse Practitioner 4789861600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Track Urgent CareGroup PAC ID 5799005070, 41 clinicians

Practice addresses (Care Compare)

17910 Bulverde Rd
Suite 115
San Antonio, TX 78259-3762
Phone (210) 906-8478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
648078TXMDAdult Health Nurse Practitioner
AP116948TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PVD Urgent Care LLC CurrentSince Jul 3, 2017 Accepting new patients
PVD Urgent Care LLC CurrentSince Jul 3, 2017 Accepting new patients
Fast Track Urgent Care CurrentSince Nov 29, 2016 Accepting new patients
Fast Track Urgent Care - Bastrop CurrentSince Nov 29, 2016 Accepting new patients
Emergency Medical Associates of Tampa Bay, LLC Past Accepting new patients
St. David'S Carenow Urgent Care PLLC Past Accepting new patients

Locations

17910 Bulverde Rd
Ste 115
San Antonio, TX 78259
Phone (210) 906-8478

18007 Ih 10 W
San Antonio, TX 78257
Phone (210) 530-1040

12007 Alamo Ranch Pkwy
Ste 124
San Antonio, TX 78253
Phone (210) 405-0507

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1043467145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 CULEBRA RD LOT 84",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782534826",
            "telephone_number": "210-379-0501",
            "fax_number": "210-314-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 CULEBRA RD LOT 84",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782534826",
            "telephone_number": "210-379-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "middle_name": "P",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "648078",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP116948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.