MEDICARE: DR. WILLIAM EASTON WALKER 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	F6158	TX
2	207P00000X	Emergency Medicine Physician	F6158	TX

General Provider Information

NPI Number	:	1619242047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM EASTON WALKER M.D.

Provider Business Mailing Address
First Line	:	2831 SACKETT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1125
Country	:	US
Telephone Number	:	713-520-0021
Fax Number	:

Provider Business Practice Location Address
First Line	:	2831 SACKETT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1125
Country	:	US
Telephone Number	:	713-520-0021
Fax Number	:

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

Provider Enumeration Date	:	03/19/2012
Last Update Date	:	04/29/2015

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