NPIMap

Individual provider Active NPI

Mark Wilson, MD

  • Emergency Medicine Physician
  • Bryan, TX
National Provider Identifier
1679660682
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
N1225 Issued in TX
Practice address
3134 Briarcrest Dr
Bryan, TX 77802-3014
Phone
(979) 314-2323
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 22

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20081203000452 TX Practitioner - Emergency MedicinePractitioner - Internal Medicine 2163526229 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Scurry County Hospital District CurrentSince Jan 1, 2024 Accepting new patients
Liberty County Hospital District No 1 Current Accepting new patients
Cahrmc CurrentSince Jul 4, 2023 Accepting new patients
Scurry County Hospital District CurrentSince Jan 1, 2024 Accepting new patients
Scurry County Hospital District CurrentSince Aug 8, 2025 Accepting new patients
Seminole Hospital District of Gaines County Texas CurrentSince Jul 1, 2021 Accepting new patients
Cahrmc Current Accepting new patients
Liberty County Hospital District No 1 CurrentSince Jul 30, 2024 Accepting new patients
Seminole Hospital District of Gaines County Texas Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Liberty County Hospital District No 1 CurrentSince Jul 30, 2024 Accepting new patients
Bryan Emergency Physicians PA Emergency Medicine Past Accepting new patients
Taylor Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Trinity Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Adel Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine Past Accepting new patients
Seminole Hospital District of Gaines County Texas Past Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients
Freestone Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Perry Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Austin Premier Emergency Physicians Emergency Medicine Past Accepting new patients
Houston Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Rusk Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients

Locations

600 S Austin Rd
Eagle Lake, TX 77434
Phone (979) 234-5571

1011 S Dill St
East Bernard, TX 77435
Phone (979) 335-4433

1353 N Travis St
Liberty, TX 77575
Phone (936) 336-7316

209 NW 8th St
Seminole, TX 79360
Phone (432) 758-5811

1004 Hobbs Hwy
Ste 4
Seminole, TX 79360
Phone (432) 758-4777

1700 Cogdell Blvd
#D
Snyder, TX 79549
Phone (325) 574-7439

1700 Cogdell Blvd
Snyder, TX 79549
Phone (325) 573-6374

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X N1225 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

3134 Briarcrest Dr
Bryan, TX 77802-3014

Mailing address

17268 Eagle Pass Dr
College Station, TX 77845-4567
Phone (979) 217-1317

Other practice location 1

209 NW 8th St
Seminole, TX 79360-3447
Phone (432) 758-5811

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 1, 2021.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1679660682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17268 EAGLE PASS DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454567",
            "telephone_number": "979-217-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 BRIARCREST DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023014",
            "telephone_number": "979-314-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 NW 8th St",
            "address_purpose": "LOCATION",
            "city": "Seminole",
            "state": "TX",
            "postal_code": "793603447",
            "country_code": "US",
            "telephone_number": "432-758-5811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N1225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.