Individual provider Active NPI

Thomas Laurence Wilson, MD

  • Obstetrics & Gynecology Physician
  • Texarkana, TX
National Provider Identifier
1760470439
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G7024 Issued in TX
Practice address
2602 Saint Michael Dr
Suite 201a
Texarkana, TX 75503-2387
Phone
(903) 792-1216
Fax
(903) 614-5299
NPI assigned
Oct 7, 2005
Last updated
Jan 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G7024 TX Primary

Addresses

Primary practice location

2602 Saint Michael Dr
Suite 201a
Texarkana, TX 75503-2387

Mailing address

2602 Saint Michael Dr Ste 201a
Texarkana, TX 75503-2387
Phone (903) 792-1216

Other identifiers 4

IdentifierTypeStateIssuer
097982501MedicaidTX
11368001MedicaidAR
00DF12OtherTXBC/BS
89358OtherARBLUE CROSS

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040611001075 TX Practitioner - Obstetrics/Gynecology 6002899721 Practice locations: Texarkana, TX

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Oklahoma College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2602 Saint Michael Dr
Texarkana, TX 75503-2387
Phone (903) 614-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Health Ark-la-Tex Past Accepting new patients
Medical Center Medical Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: twilson310750@christushealth.direct-ci.net

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1760470439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 SAINT MICHAEL DR STE 201A",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032387",
            "telephone_number": "903-792-1216",
            "fax_number": "903-614-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 SAINT MICHAEL DR",
            "address_2": "SUITE 201A",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032387",
            "telephone_number": "903-792-1216",
            "fax_number": "903-614-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "THOMAS",
        "middle_name": "LAURENCE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "G7024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097982501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11368001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "00DF12",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "89358",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.