Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Destonee Wilson, PA-C

Individual provider Physician Assistant · NPI 1174041578

Destonee Wilson, PA-C is a Physician Assistant in Fort Worth, Texas. Qualified in 2017, 9 years ago. Practices with Privia Medical Group Gulf Coast PLLC, a 538-clinician group, works from 5 locations, accepts Medicare assignment and offers telehealth. Licensed in Texas and Utah.

Years since qualifying
9
Licensed in
TX, UT
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1650 S Beach St
Fort Worth, TX 76105
Phone: (817) 702-1100
Fax: (817) 702-6124
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 13953 S Bangerter Pkwy, Draper, UT 84020-5429 — (385) 900-4090
  • 2295 S Foothill Dr, Salt Lake City, UT 84109-4000 — (801) 486-3021
  • 2295 S Foothill Dr, Salt Lake City, UT 84109-4000 — (801) 486-3021
  • 6360 S 3000 E Ste 100, Salt Lake City, UT 84121-6924 — (801) 365-1032

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA12177 (TX)
Physician Assistant Taxonomy 363A00000X · Licence 279726-1206 (UT)

Record details

NPI number1174041578
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 6, 2017
Last updated in NPPESNovember 7, 2018
Mailing addressPo Box 732973, Dallas, TX 75373-2973

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Privia Medical Group Gulf Coast Pllc — 538 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Fort Worth