Dan E Wilson Jr., D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

K-6414 Issued in TX

Practice address

425 Holderrieth Blvd
Suite206
Tomball, TX 77375-4543

Phone

(281) 357-5454

Fax

(281) 357-5499

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Baylor College of Medicine

  • Ph.D. Medical Genetics
  • Houston, TX
  • NPI 1881026664

  Physical Medicine & Rehabilitation

  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226275200000",
    "number": "1801848312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 HOLDERRIETH BLVD",
            "address_2": "SUITE206",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754543",
            "telephone_number": "281-357-5454",
            "fax_number": "281-357-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 HOLDERRIETH BLVD",
            "address_2": "SUITE206",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754543",
            "telephone_number": "281-357-5454",
            "fax_number": "281-357-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "K-6414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148843003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Camille Williams, SLP
• Roderick Shaun Williams, LAT
• Willow Creek Smiles PLLC
• Harold David Wills, MD
• Christine Wilson, NP
• Holly Lynn Wilson, CMHC
• Benisha Laportia Wiltz-Kargou, M.D.
• Craig Alan Winkler, M.D.
• Winnie-Stowell Hospital District
• Winnie-Stowell Hospital District

• All providers in Tomball, TX
• Physical Medicine & Rehabilitation Physician in Texas

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