Provider Demographics
NPI:1952612939
Name:WILSON, BETSY SUE (DC)
Entity type:Individual
Prefix:DR
First Name:BETSY
Middle Name:SUE
Last Name:WILSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3619 MAHEJAN DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584
Mailing Address - Country:US
Mailing Address - Phone:318-717-0250
Mailing Address - Fax:
Practice Address - Street 1:1018 HERCULES AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2722
Practice Address - Country:US
Practice Address - Phone:281-480-7000
Practice Address - Fax:281-480-7017
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor