MEDICARE: DR. WILLIAM C PEDERSON M.D.

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
1	2086S0122X	Plastic and Reconstructive Surgery Physician	F1893	TX
2	2086S0105X	Surgery of the Hand (Surgery) Physician	F1893	TX
3	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	F1893	TX
4	208200000X	Plastic Surgery Physician	F1893	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1053387902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM C PEDERSON M.D.

Provider Business Mailing Address
First Line	:	6701 FANNIN ST STE 610.00
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2608
Country	:	US
Telephone Number	:	832-822-3180
Fax Number	:

Provider Business Practice Location Address
First Line	:	1977 BUTLER BLVD STE E6100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4101
Country	:	US
Telephone Number	:	713-798-6141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	12/29/2025

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