Individual ProviderMary H WilsonOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4208 Retama Cir, Victoria, TX 77901-2765(361) 582-0611(361) 579-8517PECOS EnrollmentBased on the most recent information from CMS, provider Mary H Wilson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1942580550Provider TypeIndividualFull NameWilson, Mary HCredentialOTGenderFemaleSole ProprietorNoEnumeration Date8/26/2011Last Updated8/26/2011Contact InformationPractice LocationPractice Address4208 Retama Cir, Victoria, TX 77901-2765Phone(361) 582-0611Fax(361) 582-4805Mailing LocationMailing Address503 Brooks Rd, Victoria, TX 77904-1468Phone(361) 579-8517FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense100728Texas