DR. BRADEN WILSON (NPI# 1558820381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558820381 |
| Entity Type | Individual |
| Full Name | DR. BRADEN WILSON |
| Credential | MD |
| Practice Address |
2401 S 31st St # Ms 01161b Temple TX 76508-0001 |
| Practice Telephone | 2547242364 |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2020-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | BP20073168 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | PHYSICIAN IN TRAINING | BP20073168 | 01 |
| Street Address |
2401 S 31ST ST # MS 01161B |
| City | TEMPLE |
| State | TX |
| Zip Code | 76508-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275037905 | Taylor William Clements | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2018-03-19 |
| 1477181667 | Pruthali Kulkarni | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2020-04-01 |
| 1467080622 | Imran Mohammed Qureshi | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2020-03-31 |
| 1154958387 | Shirley Cotty Reed | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2020-03-26 |
| 1982231015 | Allen Zacharia Jacob | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2020-03-26 |
| 1568099687 | Heather Marie Villarreal | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2020-03-26 |
| 1841827268 | Austin Lunney | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2020-03-25 |
| 1538796172 | Tayler Acton | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2020-03-24 |
| 1073140612 | Kadilee Adams | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2020-03-24 |
| 1447887930 | Hayden Graham Smiley | Student in an Organized Health Care Education/Training Program | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2020-03-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619596491 | Samuel Adrian Matthys | Student in an Organized Health Care Education/Training Program | 2401 South 31st St, Ms-ag-407q, Temple, TX 76508 | 2020-04-13 |
| 1700414968 | Darshan Patel | Student in an Organized Health Care Education/Training Program | 2401 South 31st Street, Ms-ck-300-kessiah Foster, Temple, TX 76508 | 2020-03-31 |
| 1992332134 | Kiersi Harmon | Student in an Organized Health Care Education/Training Program | 2401 South 31st Street Ms-ag-303h, Baylor Scott & White Medical Center-temple, Temple, TX 76508 | 2020-03-26 |
| 1053948851 | Christian Beltran | Student in an Organized Health Care Education/Training Program | 2410 South 31st Street, Ms 01 161b, Temple, TX 76508 | 2020-03-24 |
| 1790311850 | Chinyere Ashley Onyirimba | Student in an Organized Health Care Education/Training Program | Baylor Scott & White Medical Center - Temple, 2401 South 31st Street, Ms-ag-303h, Temple, TX 76508 | 2020-03-19 |
| 1578022398 | Kedric Glenn | Student in an Organized Health Care Education/Training Program | 2401 South 31st Street, Ms-11-ag062, Temple, TX 76508 | 2019-03-19 |
| 1518426592 | Muhammad Imran Bhatti | Student in an Organized Health Care Education/Training Program | Baylor Scott and White Medical Center-temple 2401, South 31st Street Ms-01-161b, Temple, TX 76508 | 2019-03-18 |
| 1780143883 | Nathaniel Clayton Palmer | Student in an Organized Health Care Education/Training Program | 2401 South 31st Street, Ms-s2-663 Temple, Texas 76508, Temple, TX 76508 | 2019-03-18 |
| 1235620741 | Fahmida Musharof | Student in an Organized Health Care Education/Training Program | 2401 S 31st Street, Ms-ck-300, Temple, TX 76508 | 2018-05-21 |
| 1275038325 | Robert Casey Alan Finch | Student in an Organized Health Care Education/Training Program | 2401 S 31st St, Ms-ck-300, Temple, TX 76508 | 2018-03-29 |
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| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518461722 | Maxwell Su | Ophthalmology | Baylor Scott & White Medical Center, 2401 South 31st Street, Ms-01-161b, Temple, TX 76508 | 2018-03-21 |
| 1932416013 | Richard Donald Cunningham | Ophthalmology | 3710 Sierra Blanca Blvd, Temple, TX 76502-1660 | 2010-09-09 |
| 1316908395 | Mark Morgan | Ophthalmology | 1815 S 31st St, Temple, TX 76504-6728 | 2006-03-30 |
| 1851368286 | Jonathan H Tsai | Ophthalmology | Scott and White Eye Institute, 2401 South 31st Street, Temple, TX 76508-0001 | 2006-03-03 |
| 1194798074 | Todd Bradley Gorden | Ophthalmology | 1618 Canyon Creek Dr, Suite 120, Temple, TX 76502-3275 | 2006-02-09 |
| 1063410439 | Austin Wei Chang | Ophthalmology | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2005-07-11 |
| 1811552045 | Wesley Matthew Gillette | Ophthalmology | 2401 S 31st St, Temple, TX 76508-0001 | 2019-05-02 |
| 1750842894 | Lauren Michelle Ehle | Ophthalmology | 2401 S 31st St, Temple, TX 76508-0001 | 2019-03-30 |
| 1821593955 | Matthew Nickell | Ophthalmology | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | 2018-03-29 |
| 1891299111 | Jacob Fleenor | Ophthalmology | 2401 S 31st St, Temple, TX 76508-0001 | 2018-03-21 |
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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.