| Provider / Organization | NPI | Date Certified |
|---|---|---|
| IDARA WILSON | 1922696426 | 2021-01-10 |
Idara Wilson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1922696426. Registration indicates Idara Wilson is a provider of services with a specialization in Pharmacy Service Providers, Pharmacist (Pharmacist, ) (Pharmacist, Pharmacy Service Providers)
| Entity Type | Individual |
| Provider Name | Dr. Idara Wilson |
| Practice Office Address | 7440 FM 1960 RD E HUMBLE, TX US |
| Practice Office Telephone | 2818528088 |
| Mailing Address | 2223 PARKVIEW LN MISSOURI CITY, TX 774594459 US |
| Business Telephone | 8324550711 |
| Code | Practice | License No State |
|---|---|---|
| 183500000X PRIMARY | Pharmacy Service Providers Pharmacist Pharmacist Pharmacist Pharmacy Service Providers | 68036
TX |