=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952305443
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM L HIGH MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2005
-----------------------------------------------------
Last Update Date | 03/18/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2910 FANNIN ST STE B
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77701-3901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-833-0093
-----------------------------------------------------
Fax | 409-833-7118
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2910 FANNIN ST STE B
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77701-3901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-833-0093
-----------------------------------------------------
Fax | 409-833-7118
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | F2708
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------