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

Dr. Thaddeus David Wilson, MD

Individual provider Pediatric Emergency Medicine (Emergency Medicine) Physician · NPI 1417190869

Dr. Thaddeus David Wilson, MD is a Pediatric Emergency Medicine (Emergency Medicine) Physician in San Antonio, Texas. Works from 2 locations. Licensed in Tennessee and Texas.

Licensed in
TN, TX
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

4204 Gardendale St Ste 312
San Antonio, TX 78229-3132
Phone: (210) 293-6003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 400 N State Of Franklin Rd, Johnson City, TN 37604-6035 — (423) 431-6111

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 58235 (TN)
Pediatric Emergency Medicine (Emergency Medicine) Physician Taxonomy 207PP0204X · Licence Q4343 (TX)

Record details

NPI number1417190869
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 15, 2009
Last updated in NPPESFebruary 21, 2019
Mailing address4204 Gardendale St, Suite 312, San Antonio, TX 78229-3132

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