Provider Demographics
NPI:1144657586
Name:WILSON, ALANA NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:NICOLE
Last Name:WILSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 PINECROFT DR
Mailing Address - Street 2:SUITE 460
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3279
Mailing Address - Country:US
Mailing Address - Phone:281-853-5308
Mailing Address - Fax:281-377-0946
Practice Address - Street 1:9200 PINECROFT DR
Practice Address - Street 2:SUITE 460
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3279
Practice Address - Country:US
Practice Address - Phone:281-853-5308
Practice Address - Fax:281-377-1946
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical