Provider Demographics
NPI:1972394948
Name:WILSON, AMBER NOEL (RD)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:NOEL
Last Name:WILSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16825 HARKEY RD
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5053
Mailing Address - Country:US
Mailing Address - Phone:832-472-1478
Mailing Address - Fax:
Practice Address - Street 1:16825 HARKEY RD
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5053
Practice Address - Country:US
Practice Address - Phone:832-472-1478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06676133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered