DR. TOM W. WILSON (NPI# 1083626477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083626477 |
| Entity Type | Individual |
| Full Name | DR. TOM W. WILSON |
| Credential | PHARMD. |
| Practice Address |
4800 Memorial Dr Waco TX 76711-1329 |
| Practice Telephone | 2542973022 |
| Practice Fax Number | 2542975378 |
| Mailing Telephone | 2542973022 |
| Mailing Fax Number | 2542975378 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1300X |
Pharmacist Specialization: Psychiatric |
19535 | TX | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | LICENSE NUMBER | 19353 | 01 |
| Street Address |
4800 MEMORIAL DR |
| City | WACO |
| State | TX |
| Zip Code | 76711-1329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255331013 | Raymond C Lisauckis | Counselor | 4800 Memorial Dr, Va Medical Center (124-vist-w), Waco, TX 76711-1329 | 2005-07-22 |
| 1558978817 | Macey Lynn Everett | Nutritionist | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-09-29 |
| 1659980696 | Najeeah Smith | Social Worker | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-07-27 |
| 1679100309 | Sara Mariem Ramadan | Nurse Practitioner | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-03-24 |
| 1225660798 | Tiffany A Wilson | Licensed Practical Nurse | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-02-12 |
| 1972142164 | Sheri Lynn Shaw | Nurse Practitioner | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-01-05 |
| 1366085953 | Ashley P Evans | Registered Nurse | 4800 Memorial Dr, Waco, TX 76711 | 2019-10-25 |
| 1669021184 | Marian Nichole Guerrero | Nurse Practitioner | 4800 Memorial Dr, Waco, TX 76711-1329 | 2019-09-06 |
| 1003463191 | Paul Cook | Physical Therapist | 4800 Memorial Dr, Waco, TX 76711-1329 | 2019-08-22 |
| 1346892601 | Austen Anderson | Psychologist | 4800 Memorial Dr, Waco, TX 76711-1329 | 2019-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467090548 | Nps Care LLC | Pharmacy | 1401 S Valley Mills Drive, Beverly Hills, TX 76711 | 2019-12-19 |
| 1033684352 | Open Arms Healthcare of Texas Inc. | Clinic/Center | 1437 S. Valley Mills Drive, Waco, TX 76711 | 2018-10-13 |
| 1093178733 | Access Dental of Valley Mills Pa | Dentist | 311401 S Valley Mills Drive, Waco, TX 76711 | 2016-03-31 |
| 1134501869 | Market Place Health Care, LLC | Skilled Nursing Facility | 2430 Market Place Drive, Waco, TX 76711 | 2015-06-18 |
| 1184038507 | Visn 17 Center of Excellence for Research On Returning War Veterans | Psychiatric Hospital | 4800 Veterans Memorial Drive, 151-c, Waco, TX 76711 | 2014-06-13 |
| 1053606228 | Clenny Edward Terrell | Pharmacist | 1520 S. Valley Mills Dr., Bevely Hills, TX 76711 | 2011-06-15 |
| 1225342926 | Geoffrey May | Psychiatry & Neurology | 4800 Memorial Drive (151c), Waco, TX 76711 | 2010-08-05 |
| 1184846685 | David Charles Chandler | Specialist/Technologist | Baylor Athletic Department, 150 Bear Run, Waco, TX 76711 | 2007-05-03 |
| 1326177601 | Minh D Nguyen | Family Medicine | 4800 Memorial Dr Bldg 4, Waco, TX 76711 | 2007-03-05 |
| 1376652719 | H-e-b, Lp | Clinical Medical Laboratory | 1821 S Valley Mills Dr, Waco, TX 76711 | 2006-08-30 |
| Find all providers in zip 76711 | ||||
| Taxonomy Code | 1835P1300X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Psychiatric |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and monitoring patients, recognizing drug-induced problems, and recommending appropriate treatment plans. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669900833 | Samantha Marie Vogel | Pharmacist | 1301 W 38th St Ste 700, Austin, TX 78705-1016 | 2017-05-31 |
| 1053761676 | Nina Vadiei | Pharmacist | 3400 Harmon Ave Apt 469, Austin, TX 78705-2375 | 2016-06-14 |
| 1407106750 | Morgan Snyder | Pharmacist | 7603 Eastcrest Dr, Austin, TX 78752-1409 | 2012-09-13 |
| 1336341254 | Jerry Wade Lee | Pharmacist | 1950 Aspen, Lubbock, TX 79403 | 2007-06-04 |
| 1104047364 | Ronald Leon Thomas | Pharmacist | 1350 N. Westmoreland, Pharmacy Service, Dallas, TX 75211 | 2007-05-02 |
| 1184717688 | Crystal Henderson | Pharmacist | 1001 Lake Carolyn Pkwy Apt 516, Irving, TX 75039-4816 | 2006-10-02 |
| 1174513972 | Catherine Susan Hall | Pharmacist | 325 Wallace St, Seguin, TX 78155-5959 | 2005-10-24 |
| 1013902519 | Leah B Nunez | Pharmacist | 1401 S Rangerville Rd, Harlingen, TX 78552-7638 | 2005-09-12 |
| 1740281716 | Mishelle R Seiler | Pharmacist | 8720 Country Glen Xing, Plano, TX 75024-3780 | 2005-08-02 |
| 1427058346 | Delphina Chikamele Mitima-samuel | Pharmacist | 9727 Mckinney Ln, Missouri City, TX 77459 | 2005-07-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.