MEDICARE: WILLIAM JUSTUS HEAD MD PA

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	207W00000X	Ophthalmology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811939184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM JUSTUS HEAD MD PA

Provider Business Mailing Address
First Line	:	5111 N 10TH ST
Second Line	:	PMB 210
City	:	MCALLEN
State	:	TX
Zip	:	78504-2835
Country	:	US
Telephone Number	:	956-631-4533
Fax Number	:	956-631-4335

Provider Business Practice Location Address
First Line	:	605 E VIOLET AVE
Second Line	:	SUITE 2
City	:	MCALLEN
State	:	TX
Zip	:	78504-2481
Country	:	US
Telephone Number	:	956-631-4533
Fax Number	:	956-631-4335

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM JUSTUS HEAD III
Credential	:	M.D.
Telephone Number	:	956-631-4533

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	07/10/2012

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