Active NPI
Tisha Lique Wilson
- Durable Medical Equipment & Medical Supplies
- San Antonio, TX
National Provider Identifier
1861373532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 1551189
- Practice address
- 1231 Austin Hwy Ste 103
San Antonio, TX 78209-4982 - Phone
- (504) 385-5751
- NPI assigned
- Sep 10, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 1551189 | TX | Primary |
Addresses
Primary practice location
1231 Austin Hwy Ste 103
San Antonio, TX 78209-4982
Mailing address
PO Box 90005
San Antonio, TX 78209-9005
Phone (504) 385-5751
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1551189 | TX | MD | Durable Medical Equipment & Medical Supplies |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757462400000",
"number": "1861373532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 90005",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782099005",
"telephone_number": "504-385-5751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1231 AUSTIN HWY STE 103",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782094982",
"telephone_number": "504-385-5751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TISHA",
"middle_name": "LIQUE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-09-10",
"last_updated": "2025-09-10",
"certification_date": "2025-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "TX",
"license": "1551189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.