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NPI Code Detail

MEDICARE: DR. PATRICK WAYNE WILLS MD

MEDICARE:  DR. PATRICK WAYNE WILLS  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianF0083TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110130882OTHERTXRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
310014444OTHERTXAMERIGROUP

General Provider Information

NPI Number : 1053307264
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK WAYNE WILLS MD
Provider Business Mailing Address
First Line : 5126 DOLIVER DR
Second Line :
City : HOUSTON
State : TX
Zip : 77056-2408
Country : US
Telephone Number : 713-569-8150
Fax Number : 281-929-0585
Provider Business Practice Location Address
First Line : 1315 ST JOSEPH PKWY STE 1102
Second Line :
City : HOUSTON
State : TX
Zip : 77002-8235
Country : US
Telephone Number : 281-868-1094
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 10/16/2024

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Directions to “ DR. PATRICK WAYNE WILLS MD” Practice Location

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