Provider Demographics
NPI:1508838814
Name:LANDERS, WILSON H JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILSON
Middle Name:H
Last Name:LANDERS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:50 MEDICAL DRIVE
Mailing Address - Street 2:STE 300
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79007-7579
Mailing Address - Country:US
Mailing Address - Phone:806-467-5894
Mailing Address - Fax:806-274-9520
Practice Address - Street 1:50 MEDICAL DRIVE
Practice Address - Street 2:STE 300
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-7579
Practice Address - Country:US
Practice Address - Phone:806-467-5894
Practice Address - Fax:806-274-9520
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
TXF1728207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF1728OtherSTATE LICENSE NUMBER
TXY0035665OtherDPS NUMBER
TXY0035665OtherDPS NUMBER
TXF1728OtherSTATE LICENSE NUMBER