DR. JON M WILSON JR. (NPI# 1104970862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104970862 |
| Entity Type | Individual |
| Full Name | DR. JON M WILSON JR. |
| Credential | DPM |
| Practice Address |
615 N Zaragoza Rd El Paso TX 79907-4773 |
| Practice Telephone | 9858670301 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 3020 | TX | Podiatric Medicine & Surgery Service Providers |
| N | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
DPM.200036 | LA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0000X |
Podiatrist Specialization: Sports Medicine |
DPM.200036 | LA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
DPM.200036 | LA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
DPM.200036 | LA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | LA STATE LICENSE | DPM.200036 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750936282 | Jon Randolph Wilson | Acupuncturist | 3844b Keanu St, Honolulu, HI 96816-4263 | 2019-08-01 |
| 1407270499 | Jon Wilson | Speech-Language Pathologist | 1530 Hedington Cir, Lawrenceville, GA 30045-3718 | 2014-02-11 |
| 1871835843 | Jon Joseph Wilson | Pharmacist | 117 W Webster St, Cuba City, WI 53807-1100 | 2013-03-18 |
| 1417111329 | Jon Michael Wilson | Audiologist | 7375 W 52nd Ave Ste 310, Arvada, CO 80002-3748 | 2008-07-10 |
| 1023133030 | Jon Jeffrey Wilson | Family Medicine | 871 S Dade 201, Everton, MO 65646-7120 | 2007-03-20 |
| 1447299219 | Jon David Wilson | Chiropractor | 10850 Lowell Ave, Overland Park, KS 66210-1613 | 2006-06-06 |
| 1407816218 | Jon Daniel Wilson | Pathology | 10810 Executive Center Dr Ste 100, Little Rock, AR 72211-4386 | 2006-03-24 |
| 1811529183 | Jon Kevin Wilson | Behavior Technician | 27777 Inkster Rd, Farmington Hills, MI 48334-5326 | 2020-02-05 |
| 1801435672 | Jon D. Wilson | Behavior Technician | 225 Cedar Hill St Ste 200, Marlborough, MA 01752-5900 | 2019-12-27 |
| 1285885483 | Jon Darren Wilson | Physician Assistant | 3601 S 6th Ave, Tucson, AZ 85723-0001 | 2008-10-06 |
| Street Address |
615 N ZARAGOZA RD |
| City | EL PASO |
| State | TX |
| Zip Code | 79907-4773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770990442 | Changhun Kim | Dentist | 615 N Zaragoza Rd, El Paso, TX 79907-4773 | 2014-07-15 |
| 1750684106 | Arturo Ayala Vieyra | Dentist | 615 N Zaragoza Rd, El Paso, TX 79907-4773 | 2010-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942782537 | Monica Patricia Ogaz | Nurse Practitioner | 615 N Zaragoza Rd Ste 86, El Paso, TX 79907 | 2018-08-30 |
| 1881078285 | Dominion Medical Services Pllc | Family Medicine | 1030 N. Zaragoza, Suite X, El Paso, TX 79907 | 2015-07-15 |
| 1144625849 | Dezirae Senclair | Registered Nurse | 316 Granillo, El Paso, TX 79907 | 2014-10-24 |
| 1124421938 | Sweet Home Adult Day Care LLC | Clinic/Center | 8615 San Juan Lane Building 19, El Paso, TX 79907 | 2014-10-07 |
| 1689995037 | Texas Senior & Disabled Day Care, L.L.C. | Clinic/Center | 1223 N. Lee Trevino Dr., El Paso, TX 79907 | 2010-06-21 |
| 1891022323 | Alderete Enterprises LLC | Clinic/Center | 8615 San Juan, Building - 19, El Paso, TX 79907 | 2009-11-04 |
| 1376707166 | Preferred Adult Day Care Center LLC | Clinic/Center | 8825 North Loop, Suites 118-119, El Paso, TX 79907 | 2008-07-11 |
| 1154500379 | North Mesa Dental, PC | Dentist | 615 Zargoza Road, Suite 88, El Paso, TX 79907 | 2007-10-25 |
| 1700816089 | David Lynn Butterfield | Specialist/Technologist | 5932 Quail Ave, El Paso, TX 79907 | 2006-07-03 |
| 1922080118 | Alfredo Aguayo | Chiropractor | 1030 North Zaragoza, Suite O, El Paso, TX 79907 | 2005-11-15 |
| Find all providers in zip 79907 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265604532 | Arma Velasquez,d.p.m | Podiatrist | 8920 Gateway East Blvd., Suite 1, El Paso, TX 79907-1828 | 2008-03-27 |
| 1629117080 | Gabriel Lazar | Podiatrist | 1635 N Lee Trevino Dr Ste C, El Paso, TX 79936-5175 | 2007-02-05 |
| 1700988441 | Nosratollah Heidarian Sr. | Podiatrist | 9530 Viscount Ste 2p, El Paso, TX 79925 | 2006-09-02 |
| 1821029505 | David Brent Williams | Podiatrist | 1533 N Lee Trevino Dr, C1, El Paso, TX 79936-5170 | 2006-07-05 |
| 1356384622 | Foot Specialists of El Paso | Podiatrist | 1501 N Mesa St, Suite 104, El Paso, TX 79902-4046 | 2006-06-14 |
| 1275581068 | Hao Quang Do | Podiatrist | 1850 Hunter Dr., Ste. 107, El Paso, TX 79915-1549 | 2006-05-04 |
| 1477526457 | Ep Foot Care, Pa | Podiatrist | 4659 Cohen Ave., Suite A, El Paso, TX 79924-4415 | 2006-02-09 |
| 1750352449 | Charles I Pittle | Podiatrist | 1225 E Cliff Dr Ste 2a, El Paso, TX 79902-4700 | 2006-01-30 |
| 1912995895 | Gary S Grindstaff | Podiatrist | 5547 N Mesa, #a, El Paso, TX 79912 | 2005-10-13 |
| 1376542563 | Glazar Medical Pa | Podiatrist | 1635 N Lee Trevino Dr, Ste C, El Paso, TX 79936-5175 | 2005-07-19 |
| Find all providers in EL PASO | ||||
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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.