Provider Demographics
NPI:1972705820
Name:WILSON, FREDERIC JEAN FRANCOISE (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERIC
Middle Name:JEAN FRANCOISE
Last Name:WILSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:800 W HIGHWAY 290
Mailing Address - Street 2:BUILDING B, SUITE 400
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4191
Mailing Address - Country:US
Mailing Address - Phone:512-858-7474
Mailing Address - Fax:512-858-7440
Practice Address - Street 1:800 W HIGHWAY 290
Practice Address - Street 2:BUILDING B, SUITE 400
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4191
Practice Address - Country:US
Practice Address - Phone:512-858-7474
Practice Address - Fax:512-858-7440
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXN19572084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry