Destiny Deshawn Wilson, M.D
Pediatrics in Dallas, TX. Individual provider (NPI-1).
NPI number1508307752
StatusActive
Last updated in NPPESApr 1, 2022
Details
- NPI
- 1508307752
- Entity type
- Individual (NPI-1)
- Name
- Destiny Deshawn Wilson
- Credential
- M.D
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 20, 2017
- Certification date
- Apr 1, 2022
- Last updated
- Apr 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | T0673 | TX | Yes |
Practice location
7777 Forest Ln Ste 300Dallas, TX 75230-2571
Phone 972-284-7770
Mailing address
7777 Forest Ln Ste 300Dallas, TX 75230-2571
Phone 972-284-7770
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