Active NPI
Michael J Wilson, PAC
- Physician Assistant
- Dallas, TX
National Provider Identifier
1144658055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA08779
- Practice address
- 39769 LBJ Fwy
Care Now Medical Center
Dallas, TX 75237-3560 - Phone
- (972) 780-0802
- NPI assigned
- Oct 31, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA08779 | TX | Primary |
Addresses
Primary practice location
39769 LBJ Fwy
Care Now Medical Center
Dallas, TX 75237-3560
Mailing address
PO Box 9101
Coppell, TX 75019-9494
Phone (972) 745-7500
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
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1144658055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9101",
"city": "COPPELL",
"state": "TX",
"postal_code": "750199494",
"telephone_number": "972-745-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39769 LBJ FWY",
"address_2": "CARE NOW MEDICAL CENTER",
"city": "DALLAS",
"state": "TX",
"postal_code": "752373560",
"telephone_number": "972-780-0802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-31",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA08779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.