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General NPI Number Information
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NPI Number | 1609055128
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Entity Type | Organization
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Legal Business Name | WILLIAM R. EAST MD, P.A.
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 02/05/2010
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Provider Practice Location Address
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Address Line | 5211 W 9TH AVE STE 103
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City | AMARILLO
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State | TX
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Zip | 79106-4149
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Country | US
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Telephone | 806-355-7421
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Fax | 806-358-2381
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Provider Business Mailing Address
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Address Line | 5211 W 9TH AVE STE 103
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City | AMARILLO
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State | TX
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Zip | 79106-4149
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Country | US
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Telephone | 806-355-7421
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Fax | 806-358-2381
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | LENA CALLAWAY
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Credential |
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Telephone | 806-355-7421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D2215
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License Number State | TX
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