Wilson Prosthetics Clinic, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

101123 Issued in TX

Legal business name

WILSON PROSTHETICS CLINIC, LLC

Practice address

2711 Cartwright Rd
Missouri City, TX 77459-2602

Phone

(281) 403-0107

Fax

(281) 403-0113

NPI assigned

Dec 14, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Thomas Wilson, CPO-LPO-FAAOPNPI 1073722252

Title

President

Phone

(281) 403-0107

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Thomas Wilson, CPO LPO FAAOP

  • Customized Equipment (DME)
  • Missouri City, TX
  • NPI 1073722252
  NPD (past) Authorized official

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1689857450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 CARTWRIGHT RD",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592602",
            "telephone_number": "281-403-0107",
            "fax_number": "281-403-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 CARTWRIGHT RD",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592602",
            "telephone_number": "281-403-0107",
            "fax_number": "281-403-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON PROSTHETICS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-403-0107",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO-LPO-FAAOP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "101123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z05085353",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffiny Dawn Williamson, FNP
• Dashauna Nashay Willis
• Whitnee A Willrich, LPC
• Bobby Wilmore II
• Wilray LLC
• Anissia Wilson, M.S, C.F./S.L.P.
• Geoffrey Wilson, PT
• Michael Thomas Wilson, CPO LPO FAAOP
• Stephanie Alexis Wilson, DDS
• Tiffany Wilson, MFT, LCDC, LSOTP

• Prosthetic/Orthotic Supplier in Missouri City, TX
• Providers in Missouri City, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.