Active NPI
Priscilla Wilson
- Plastic and Reconstructive Surgery Physician
- Midland, TX
National Provider Identifier
1124665526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 887086
- Practice address
- 701 Tradewinds Blvd Ste B
Midland, TX 79706-3166 - Phone
- (432) 618-6772
- Fax
- (432) 618-6775
- NPI assigned
- Dec 4, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 887086 | TX | Primary |
Addresses
Primary practice location
701 Tradewinds Blvd Ste B
Midland, TX 79706-3166
Mailing address
701 Tradewinds Blvd Ste B
Midland, TX 79706-3166
Phone (432) 618-6772
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 |
|---|---|---|---|
| 887086 | TX | MD | Plastic and Reconstructive Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575417600000",
"number": "1124665526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 TRADEWINDS BLVD STE B",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797063166",
"telephone_number": "432-618-6772",
"fax_number": "432-618-6775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 TRADEWINDS BLVD STE B",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797063166",
"telephone_number": "432-618-6772",
"fax_number": "432-618-6775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "PRISCILLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-04",
"last_updated": "2019-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "TX",
"license": "887086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.