Jerry Clyde Wilson in Nacogdoches - Mental Health
Jerry Clyde Wilson - NPI 1750437158
Jerry Clyde Wilson is a Mental Health in Nacogdoches, Texas. Jerry Clyde Wilson practices all healthcare services and medical treatments related to Mental Health. The NPI Number for Jerry Clyde Wilson is 1750437158. The last update date is 2007-07-08.
Jerry Clyde Wilson's current location address is Po Box 630325, Nacogdoches, Texas. You can contact this provider via phone number 9365696562. The mailing address for Jerry Clyde Wilson is Po Box 630325, Nacogdoches, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerry Clyde Wilson |
|---|---|
| Address | Po Box 630325, Nacogdoches, Texas |
| Phone Number | 9365696562 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.S., L.P. |
NPI Number Detail
| NPI Number | 1750437158 |
|---|---|
| Provider Enumeration Date | 2007-01-26 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | Po Box 630325 |
|---|---|
| City | Nacogdoches |
| State | Texas (TX) |
| Post Code | 759630325 |
| Phone Number | 9365696562 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | 625 |
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Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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What is the unique 10-digit identifier code assigned to Jerry Clyde Wilson by the Centers for Medicare & Medicaid Services?
The Jerry Clyde Wilson has been issued the NPI (National Provider Identifier) 1750437158 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Jerry Clyde Wilson's physical address?
The Jerry Clyde Wilson is physically located at Po Box 630325, in the city of Nacogdoches, TX, with the postal code 759630325.
What is Jerry Clyde Wilson's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jerry Clyde Wilson's specialized field of practice is Mental Health, and the corresponding taxonomy code that categorizes this area of specialization is 101Ym0800X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1750437158 to Jerry Clyde Wilson?
The Centers for Medicare & Medicaid Services originally issued the 1750437158 to Jerry Clyde Wilson on 2007-01-26.
As of what date were the details pertaining to Jerry Clyde Wilson last refreshed?
The information related to the Jerry Clyde Wilson, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
NPI Number: 1528061793
Address: 103 A South Park Dr., Brownwood, TX