Provider Demographics
NPI:1124333414
Name:C H WILKINSON PHYSICIAN NETWORK
Entity type:Organization
Organization Name:C H WILKINSON PHYSICIAN NETWORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:PLANTES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-282-2613
Mailing Address - Street 1:919 HIDDEN RDG
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3813
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-4609
Practice Address - Street 1:1602 E HOUSTON ST
Practice Address - Street 2:STE C
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-5326
Practice Address - Country:US
Practice Address - Phone:361-358-9200
Practice Address - Fax:361-362-1671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health