Healthcare Provider Details

I. General information

NPI: 1548776677
Provider Name (Legal Business Name): WILLIAM JOSEPH ANDERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2017
Last Update Date: 12/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27710 LIBERTY HEIGHTS LN
FULSHEAR TX
77441-1437
US

IV. Provider business mailing address

27710 LIBERTY HEIGHTS LN
FULSHEAR TX
77441-1437
US

V. Phone/Fax

Practice location:
  • Phone: 512-456-3652
  • Fax:
Mailing address:
  • Phone: 512-456-3652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License NumberG6139
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG6139
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: