Carly M Wilson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1220196 Issued in TX

Practice address

1203 Callahan Ave
Conroe, TX 77301-1724

Phone

(512) 797-5933

NPI assigned

Jul 19, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carly M Kunze Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1760737381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12325 ARIES LOOP S",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773185228",
            "telephone_number": "512-797-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 CALLAHAN AVE",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011724",
            "telephone_number": "512-797-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CARLY",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1220196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "KUNZE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wendi J. Williams
• Branch T Willis, FNP-C
• Tracy Willis, NP-C
• Wilson Vision Associates PC
• Angelina Wilson, MS, CCC-SLP
• Cody L Wilson
• Jeannie Wilson, RN
• Kaitlin Wilson, OTR
• Kristie Wilson
• Maurice Joe Wilson, O.D.

• Physical Therapist in Conroe, TX
• Providers in Conroe, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.