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NPI Code Detail

MEDICARE: WILLIAM CRAIG POTTER

MEDICARE: WILLIAM CRAIG POTTER
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
1183500000XPharmacist48352TX
2183500000XPharmacist14644OK

General Provider Information

NPI Number : 1235445941
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM CRAIG POTTER
Provider Business Mailing Address
First Line : 300 E BASSE RD
Second Line : APT 2428
City : SAN ANTONIO
State : TX
Zip : 78209-8374
Country : US
Telephone Number : 210-860-1696
Fax Number :
Provider Business Practice Location Address
First Line : 1520 AUSTIN HWY
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78218-6039
Country : US
Telephone Number : 210-828-6871
Fax Number : 210-805-8983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2010
Last Update Date : 08/20/2010

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Directions to “ WILLIAM CRAIG POTTER ” Practice Location

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