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Contact Information

DESTONEE WILSON, PA-C
1650 S BEACH ST
FORT WORTH, TX76105
 Phone: 817-702-1100
 Fax: 817-702-6124
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for DESTONEE WILSON · (Female)

NPI Number 1174041578
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 09/06/2017
Last updated 11/07/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • TX License # PA12177
  • UT License # 279726-1206
Hospital affiliation(s)
  • JPS HEALTH NETWORK - (Acute Care)
    1500 S MAIN ST
    FORT WORTH, TX 76104
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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