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713 W Broad #200 Forney TX 75126-9107 | |
| (972) 564-0711 | |
| (972) 564-0323 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 713 W Broad #200, Forney, Texas |
| Authorized Official Name and Position | Wesley Garrett Wilson (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 9725640711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
713 W Broad #200 Forney TX 75126-9107 Ph: (972) 564-0711 | 713 W Broad #200 Forney TX 75126-9107 Ph: (972) 564-0711 |
| NPI Number | 1073707626 |
|---|---|
| Provider Enumeration Date | 08/28/2007 |
| Last Update Date | 12/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073707626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J3393 (Texas) | Primary |
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