MEDICARE: WILLIAM ERIC PACK DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	1243	TX

General Provider Information

NPI Number	:	1083702922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ERIC PACK DPM

Provider Business Mailing Address
First Line	:	690 S LOOP 336 WEST
Second Line	:	SUITE 150
City	:	CONROE
State	:	TX
Zip	:	77304-3319
Country	:	US
Telephone Number	:	936-760-1200
Fax Number	:	936-760-1210

Provider Business Practice Location Address
First Line	:	690 S LOOP 336 WEST
Second Line	:	SUITE 150
City	:	CONROE
State	:	TX
Zip	:	77304-3319
Country	:	US
Telephone Number	:	936-760-1200
Fax Number	:	936-760-1210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	01/20/2025

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Directions to “ WILLIAM ERIC PACK DPM” Practice Location

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