Welton Wayne Wilson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1062036

Practice address

19073 I 45 S Ste 145
Synergenx Health
Shenandoah, TX 77385-8744

Phone

(281) 362-5580

NPI assigned

Dec 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1568646644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19073 I 45 S STE 145",
            "address_2": "SYNERGENX HEALTH",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773858744",
            "telephone_number": "281-362-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19073 I 45 S STE 145",
            "address_2": "SYNERGENX HEALTH",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773858744",
            "telephone_number": "281-362-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WELTON",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-24",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1062036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria E Willoughby, NURSE PRACTITIONER
• Alana Nicole Wilson, PA-C
• Alexia Wilson
• Garret Lee Wilson, PT, DPT
• Leslie E Wilson, M.D.
• Tara Lyn Winkelmann, M.D.
• Abraham Winkelstein
• WKLV Lab
• Kelli Reynolds Wohlgemuth, FNP
• Women'S Healthcare Affiliates, P. a.

• Physician Assistant in Shenandoah, TX
• Providers in Shenandoah, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.