Servio Andres Wilches, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11189 Issued in TX

Practice address

6812 Harrisburg Blvd
Houston, TX 77011-4626

Phone

(713) 715-4460

NPI assigned

Dec 5, 2014

Last updated

Oct 3, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Children's Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment
• Topcare Medical PA

  dba Clinicas Mi Doctor

  • Specialist
  • Irving, TX
  • NPI 1043231400
  NPD (past)
• East Lyme Pediatric Clinic, LLC

  • Primary Care Clinic/Center
  • Niantic, CT
  • NPI 1326265745
  NPD (past)

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1720486863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W JOHN CARPENTER FWY STE 420",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392014",
            "telephone_number": "516-761-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 HARRISBURG BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770114626",
            "telephone_number": "713-715-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCHES",
        "first_name": "SERVIO",
        "middle_name": "ANDRES",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-05",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017877-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilburn Healthcare Management Services (Honey Home Care)
• Brenda Joyce Wilburn, B.S. M ED
• Chejuana Wilburn
• Morgan Lindsey Wilburn, FNP-C
• Wilcare, Inc.
• Bailey Wilcox
• Tanesha Ann Wilcox, LCDC
• Victor Thomas Wilcox Jr., M.D.
• Tawana Charlet Wilcoxon
• Falon Wilcoxson

• Physician Assistant in Houston, TX
• Providers in Houston, 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 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.