Healthcare Provider Details

I. General information

NPI: 1528220019
Provider Name (Legal Business Name): WILLIAM EDWARD MORTON LVN CNA OPAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 MAIN ST
HOUSTON TX
77030
US

IV. Provider business mailing address

7401 S MAIN
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 713-799-2300
  • Fax: 713-794-3395
Mailing address:
  • Phone: 713-799-2300
  • Fax: 713-794-3395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number1069
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number168794
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: