Healthcare Provider Details

I. General information

NPI: 1285605196
Provider Name (Legal Business Name): WILLIAM BLAISEDALE BETTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3218 PARK HILLS DR
AUSTIN TX
78746-5573
US

IV. Provider business mailing address

3218 PARK HILLS DR
AUSTIN TX
78746-5573
US

V. Phone/Fax

Practice location:
  • Phone: 512-327-5354
  • Fax: 512-327-5466
Mailing address:
  • Phone: 512-327-5354
  • Fax: 512-327-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberH6049
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: