Provider Demographics
NPI:1710851365
Name:MAKIA, WILSON NGOH
Entity type:Individual
Prefix:
First Name:WILSON
Middle Name:NGOH
Last Name:MAKIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 SEASIDE DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5462
Mailing Address - Country:US
Mailing Address - Phone:940-782-0450
Mailing Address - Fax:
Practice Address - Street 1:3500 SEASIDE DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-5462
Practice Address - Country:US
Practice Address - Phone:940-782-0450
Practice Address - Fax:940-782-0450
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2025063151363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health