Individual provider Active NPI

Oscar Ray Wilson, MD

  • Family Medicine Physician
  • Tyler, TX
National Provider Identifier
1245206937
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G5786 Issued in TX
Practice address
520 E Douglas Blvd
Tyler, TX 75702-8307
Phone
(903) 510-1164
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G5786 TX Primary

Addresses

Primary practice location

520 E Douglas Blvd
Tyler, TX 75702-8307

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450

Other identifiers 1

IdentifierTypeStateIssuer
128695702MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100507000773 TX Practitioner - Family Practice 7214011279 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

105 Zeid Blvd
Henderson, TX 75652-6070
Phone (903) 595-2283

1302 N Pacific St
Christus Trinity Clinic
Mineola, TX 75773-1022
Phone (903) 569-5383

18780 Interstate 20
Canton, TX 75103-3593
Phone (903) 567-4841

313 W Parker St
Christus Trinity Clinic
Elkhart, TX 75839-7612
Phone (903) 764-5626

3201 S Loop
Palestine, TX 75801-6901

520 Douglas Blvd
Tyler, TX 75702-8307
Phone (903) 593-1721

5321 S FM
14 Christus Trinity Clinic
Holly Lake Ranch, TX 75765-4839
Phone (903) 769-2990

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

650 E Lennon Dr
Christus Trinity Clinic
Emory, TX 75440-3227
Phone (903) 473-7234

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G5786TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Aug 16, 2024 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Mar 1, 2020 Accepting new patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Aug 16, 2024 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Mar 1, 2020 Accepting new patients
Trincare Inc Current Accepting new patients

Locations

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

520 Douglas Blvd
Tyler, TX 75702
Phone (903) 510-1175

3802 Manhatton Dr
Tyler, TX 75701
Phone (903) 509-8888

Interoperability endpoints

  • Direct secure messaging: owilson7926@christushealth.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1245206937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E DOUGLAS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028307",
            "telephone_number": "903-510-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "OSCAR",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G5786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128695702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.