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

Wilson Lewis Beaverstock

Individual provider Surgical Physician Assistant · NPI 1720944523

Wilson Lewis Beaverstock is a Physician Assistant in Waco, Texas. Qualified in 2025, 1 year ago. Licensed in Texas.

Years since qualifying
1
Licensed in
TX
In the registry since
2025
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Practice location Address checks out

50 Hillcrest Medical Blvd Ste 304
Waco, TX 76712-8955
Phone: (254) 202-6580
Fax: (254) 754-6589
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA20089 (TX)

Record details

NPI number1720944523
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 24, 2025
Last updated in NPPESApril 20, 2026
Certification dateApril 20, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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