Tiffany Kay Wilson, PA is a medicare enrolled "Physician Assistant" in Henrietta, Texas. Her current practice location is
412 W South St, Henrietta, Texas. You can reach out to her office (for appointments etc.) via phone at
(940) 235-3403.
Tiffany Kay Wilson is licensed to practice in Texas (license number PA04018) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1710920178.
Provider's Profile
Full Name | Tiffany Kay Wilson |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 412 W South St, Henrietta, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1710920178
- Provider Enumeration Date: 06/14/2006
- Last Update Date: 05/19/2021
Medicare PECOS Information:
- PECOS PAC ID: 0941284582
- Enrollment ID: I20050120000904
Medical Identifiers
Medical identifiers for Tiffany Kay Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710920178 | NPI | - | NPPES |
185065301 | Medicaid | TX | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 2381 (Oklahoma) | Secondary |
363A00000X | Physician Assistant | PA04018 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tiffany Kay Wilson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tiffany Kay Wilson, PA 412 W South St, Henrietta, TX 76365-3348 Ph: (940) 235-3403 | Tiffany Kay Wilson, PA 412 W South St, Henrietta, TX 76365-3348 Ph: (940) 235-3403 |
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