NPIMap

Individual provider Active NPI

Hugh H Wilson Jr., M D

  • Family Medicine Physician
  • Lubbock, TX
National Provider Identifier
1083619746
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D6212 Issued in TX
Practice address
10502 Gary Ave
Lubbock, TX 79423-6047
Phone
(806) 687-5754
Fax
(806) 687-5754
NPI assigned
Jun 17, 2005
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X D6212 TX
Family Medicine Physician 207Q00000X D6212 TX Primary

Addresses

Primary practice location

10502 Gary Ave
Lubbock, TX 79423-6047

Mailing address

10502 Gary Ave
Lubbock, TX 79423-6047
Phone (806) 687-5754

Other practice location 1

1300 S Gregg St
Big Spring, TX 79720-4325
Phone (432) 517-4557

Other identifiers 5

IdentifierTypeStateIssuer
162693902MedicaidTX
162693901MedicaidTX
458836OtherMEDICARE RHC
019049801MedicaidTX
281971602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040116000527 TX Practitioner - Family Practice 0446151054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
D6212TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hugh H Wilson Jr MD PA Family Medicine Current Accepting new patients
Eastland Memorial Hospital District Past Accepting new patients
Stonewall Memorial Hospital Family Medicine Past Accepting new patients
Stonewall Memorial Hospital Hospice and Palliative Medicine Past Accepting new patients
Eastland Memorial Hospital District Past Accepting new patients
B & W Clinic PA Family Medicine Past Accepting new patients

Locations

3626 50th St
Lubbock, TX 79413
Phone (806) 795-1800

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083619746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10502 GARY AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794236047",
            "telephone_number": "806-687-5754",
            "fax_number": "806-385-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10502 GARY AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794236047",
            "telephone_number": "806-687-5754",
            "fax_number": "806-687-5754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 S Gregg St",
            "address_purpose": "LOCATION",
            "city": "Big Spring",
            "state": "TX",
            "postal_code": "797204325",
            "country_code": "US",
            "telephone_number": "432-517-4557",
            "fax_number": "432-517-4561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HUGH",
        "middle_name": "H",
        "name_suffix": "Jr.",
        "credential": "M D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "D6212",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D6212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162693902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162693901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RHC",
            "identifier": "458836",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019049801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281971602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.