Provider Demographics
NPI:1255165544
Name:WILSON, JOHN E (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:WILSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 N MACARTHUR BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2484
Mailing Address - Country:US
Mailing Address - Phone:214-256-4125
Mailing Address - Fax:
Practice Address - Street 1:6750 N MACARTHUR BLVD STE 350
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2484
Practice Address - Country:US
Practice Address - Phone:214-256-4125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX181989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor