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General NPI Number Information
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NPI Number | 1316149578
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Entity Type | Individual
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Provider Name | WILLIAM MCDONALD HARDY JR. MSPA-C
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Gender | Male
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | PALESTINE REGIONAL MEDICAL CENTER 2900 SOUTH LOOP 256
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City | PALESTINE
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State | TX
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Zip | 75801
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Country | US
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Telephone | 903-723-0911
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Fax | 903-723-0999
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Provider Business Mailing Address
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Address Line | 540 ANDERSON COUNTY ROAD 2139
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City | PALESTINE
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State | TX
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Zip | 75801
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Country | US
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Telephone | 903-731-4307
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Fax | 903-731-4307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01693
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License Number State | TX
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