Provider Demographics
NPI:1649922204
Name:WILSON, FAITH ELIABETH (DC)
Entity type:Individual
Prefix:DR
First Name:FAITH
Middle Name:ELIABETH
Last Name:WILSON
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18314 KINGS ROW
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3228
Mailing Address - Country:US
Mailing Address - Phone:713-261-4996
Mailing Address - Fax:
Practice Address - Street 1:211 FM 646 RD W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3036
Practice Address - Country:US
Practice Address - Phone:713-893-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor