Healthcare Provider Details

I. General information

NPI: 1891734356
Provider Name (Legal Business Name): WILLIAM A. WALKER III D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S DAIRY ASHFORD ST SUITE 114
HOUSTON TX
77077-3854
US

IV. Provider business mailing address

15519 CLOUD TOP
SAN ANTONIO TX
78248-1348
US

V. Phone/Fax

Practice location:
  • Phone: 281-558-3440
  • Fax:
Mailing address:
  • Phone: 210-493-8933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number17380
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: