MEDICARE: WILLIAM JOSEPH ANDERSON MD

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	202C00000X	Independent Medical Examiner Physician	G6139	TX
2	207X00000X	Orthopaedic Surgery Physician	G6139	TX

General Provider Information

NPI Number	:	1548776677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM JOSEPH ANDERSON MD

Provider Business Mailing Address
First Line	:	27710 LIBERTY HEIGHTS LN
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-1437
Country	:	US
Telephone Number	:	512-456-3652
Fax Number	:

Provider Business Practice Location Address
First Line	:	27710 LIBERTY HEIGHTS LN
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-1437
Country	:	US
Telephone Number	:	512-456-3652
Fax Number	:

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

Provider Enumeration Date	:	12/27/2017
Last Update Date	:	12/27/2017

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