MEDICARE: ROBERT P WILLS MD PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	363AM0700X	Medical Physician Assistant
3	363LF0000X	Family Nurse Practitioner
4	208100000X	Physical Medicine & Rehabilitation Physician
5	101YP2500X	Professional Counselor
6	111N00000X	Chiropractor
7	225100000X	Physical Therapist
8	363LA2200X	Adult Health Nurse Practitioner
9	104100000X	Social Worker
10	207LP2900X	Pain Medicine (Anesthesiology) Physician
11	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician
12	208VP0014X	Interventional Pain Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DA4560	OTHER	TX	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0015JK	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1407847957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT P WILLS MD PLLC

Provider Business Mailing Address
First Line	:	2501 W WILLIAM CANNON DR
Second Line	:	SUITE 401
City	:	AUSTIN
State	:	TX
Zip	:	78745-5253
Country	:	US
Telephone Number	:	512-416-7246
Fax Number	:	512-275-2833

Provider Business Practice Location Address
First Line	:	2501 W WILLIAM CANNON DR
Second Line	:	SUITE 401
City	:	AUSTIN
State	:	TX
Zip	:	78745-5253
Country	:	US
Telephone Number	:	512-416-7246
Fax Number	:	512-275-2833

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT P. WILLS
Credential	:	MD
Telephone Number	:	512-416-7246

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	12/28/2015

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