Provider Type Icon

GREGORY STEPHAN WILSON MD NPI 1659364263


NPI Information

NPI: 1659364263
Provider Name: GREGORY STEPHAN WILSON, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1001 SOUTH NOLAN RIVER RD
CLEBURNE, TX
ZIP 76033
Phone: (817) 517-9466
Get Directions

Gregory Stephan Wilson, MD is a family medicine in Cleburne, TX with 43 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Gregory Stephan Wilson, MD NPI is 1659364263. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduation Year:1981

The provider's business location address is:

1001 SOUTH NOLAN RIVER RD
CLEBURNE, TX
ZIP 76033-501
Phone: (817) 517-9466
Fax: (817) 556-9156

The NPI 1659364263 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/30/2005 and was last updated on 8/8/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineG0293TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100DR73OTHERTEXASBLUE CROSS BLUE SHIELD
2121512101MEDICAIDTEXAS
3121512104OTHERTEXASTEXAS MEDICAID THSTP
41029775OTHERTEXASAMERIGROUP TEXAS, INC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.