NPI age
20 years
Enumerated 2005-11-04
● Active
Type 1 · Individual
MR. Russell Carl Wilson, P.A.-C, A.T.C.
Wilson is 1 of 46 physician assistant providers in Allen and 1 of 11022 in Texas.
Primary specialty
Physician Assistant
Plus 4 subspecialties
Licensed in
TX, NE, CO
3 states
Status
Active
No deactivations on record
Last NPPES update
2022-09-20
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 11022 active physician assistant providers in Texas.
NPI age
20 years
↑ 10 yr above median (10 yr)
State licenses
3 states
Top 92% — 7% of peers are multi-state
Subspecialties
2
In the 23% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-11Enumerated in NPPES
2005
2026
Where they practice
Practice location
1125 Raintree Cir Ste 100
Allen, TX 750135289
Mailing address
1125 Raintree Cir Ste 100
Allen, TX 750135289
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
-
Emergency Medical Technician, ParamedicAn EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards.
-
Specialist/TechnologistAthletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 360930704 | |
| 01 (TX) | 8029NH | BCBSTX |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.