Provider Demographics
NPI:1710028345
Name:WILCOX, JAMES CARSON II (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CARSON
Last Name:WILCOX
Suffix:II
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:4112 GLIDING GULLS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-2685
Mailing Address - Country:US
Mailing Address - Phone:702-487-5987
Mailing Address - Fax:
Practice Address - Street 1:3800 S W S YOUNG DR STE 201
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-3340
Practice Address - Country:US
Practice Address - Phone:254-245-9175
Practice Address - Fax:254-213-7771
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2023-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVPENDING367500000X
TXAP116710367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75876OtherNATIONAL BOARD OF CERTIFICATION & RECERTIFICATION FOR NURSE ANESTHETISTS