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MARY WILSON RD
NPI 1366115461
Dietitian, Registered in Southlake, TX

Active since July 26, 2021
620 E SOUTHLAKE BLVD, SOUTHLAKE, TX 76092(214) 623-6270 Get Directions Write a Review

NPPES record last updated: July 26, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mary Wilson Rd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY WILSON RD (NPI 1366115461) is an individual dietitian, registered in Southlake, Texas, licensed in Texas (86151599) and active in the NPI registry since July 2021. She maintains a secondary practice location in Southlake.

NPPES Registry Identity

NPI1366115461
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMARY WILSONCredential: RD
Location Address620 E SOUTHLAKE BLVDSouthlake, TX 76092-6236
Mailing Address620 E Southlake BlvdSouthlake, TX 76092-6236 · (214) 623-6270
Phone(214) 623-6270
Sole ProprietorNo
Enumeration DateJuly 26, 2021
NPPES CertifiedJuly 23, 2021
✔ NPI 1366115461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in TX · 86151599
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
620 E SOUTHLAKE BLVD, Southlake, TX 76092
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Secondary Practice Location 1

Location 1505 S Nolen DrSouthlake, TX 76092-9167 · Phone (214) 623-6270 ext. 2543

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARRIE COLE SEALE
Social Worker
620 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092
Tarrant County (469) 909-0328
ADVANCED MEDICAL ENTERPRISES LP
Durable Medical Equipment & Medical Supplies
620 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092
Tarrant County (405) 285-4914
SDG PHYSICIANS GROUP PA
Clinic/Center (Sleep Disorder Diagnostic)
620 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092
Tarrant County (817) 552-6730
SOUTHLAKE SLEEP CENTER, LTD
Clinic/Center (Sleep Disorder Diagnostic)
620 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092
Tarrant County (817) 552-6730
SOUTHLAKE CHILDRENS SLEEP CENTER, LTD
Clinic/Center (Sleep Disorder Diagnostic)
620 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092
Tarrant County (817) 552-6730

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Wilson's NPI number?

The NPI number for Mary Wilson is 1366115461. It was assigned to this individual provider in the NPPES registry on July 26, 2021.

Where is Mary Wilson located?

Mary Wilson practices at 620 E Southlake Blvd, Southlake, TX 76092. The listed phone number is (214) 623-6270.

What is Mary Wilson's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

What insurance does Mary Wilson accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Mary Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Wilson was last updated on July 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.