Stephen L Wilson MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

STEPHEN L WILSON MD PA

Doing business as

Western Medical Center

Practice address

1015 S Henderson St
Fort Worth, TX 76104-2924

Phone

(817) 870-1035

Fax

(817) 332-5005

NPI assigned

Nov 20, 2007

Last updated

Feb 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Priscilla Porras

Title

Administrator

Phone

(817) 870-1035

Specialties & licenses 1

Addresses

Other names 1

• Western Medical Center Doing business as

Locations

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1669653499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042924",
            "telephone_number": "817-870-1035",
            "fax_number": "817-332-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042924",
            "telephone_number": "817-870-1035",
            "fax_number": "817-332-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN L WILSON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "PORRAS",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "817-870-1035",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Bryan Stephens, DO

• Specialist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.