Healthcare Provider Details

I. General information

NPI: 1811939184
Provider Name (Legal Business Name): WILLIAM JUSTUS HEAD MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 E VIOLET AVE SUITE 2
MCALLEN TX
78504-2481
US

IV. Provider business mailing address

5111 N 10TH ST PMB 210
MCALLEN TX
78504-2835
US

V. Phone/Fax

Practice location:
  • Phone: 956-631-4533
  • Fax: 956-631-4335
Mailing address:
  • Phone: 956-631-4533
  • Fax: 956-631-4335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM JUSTUS HEAD III
Title or Position: PRESIDENT
Credential: M.D.
Phone: 956-631-4533