Provider Demographics
NPI:1396756565
Name:WILCOX, HOWARD D (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:D
Last Name:WILCOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:919 HIDDEN RDG
Mailing Address - Street 2:
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:469-282-0996
Practice Address - Street 1:5875 N MAJOR DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77713-9034
Practice Address - Country:US
Practice Address - Phone:409-892-2262
Practice Address - Fax:409-892-3336
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154682202Medicaid
TX1K1982OtherMEDICARE
TXP02601529OtherMCRR
TX154682202Medicaid