Troy Wilde, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT3632 Issued in TX

Practice address

Asu Station #10899
San Angelo, TX 76909-1767

Phone

(325) 659-3500

NPI assigned

Jan 29, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1770174161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ASU STATION #10899",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769090001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ASU STATION #10899",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769091767",
            "telephone_number": "325-659-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "TROY",
        "credential": "LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT3632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Joseph Wierzowiecki, PT, DPT
• Savannah Jordan Wieting
• Deborah D'Ann Wilbanks, RN
• Wilbea Medical Equipment LLC
• Brooke Wilcox
• Tara Anne Wiley, RN
• Angela D Wilke, NP-C
• Courtney Rene Wilkerson, PT, DPT
• Dakota Reign Wilkins
• Joe B Wilkinson, MD

• Athletic Trainer in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.