MEDICARE: WILLIAM VANDIVER HARFORD JR 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	207RG0100X	Gastroenterology Physician	E0957	TX

General Provider Information

NPI Number	:	1649255258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM VANDIVER HARFORD JR M.D.

Provider Business Mailing Address
First Line	:	4500 S LANCASTER RD
Second Line	:	GASTRO 111B1, DVAMC
City	:	DALLAS
State	:	TX
Zip	:	75216-7167
Country	:	US
Telephone Number	:	214-371-6441
Fax Number	:	214-857-1571

Provider Business Practice Location Address
First Line	:	4500 S LANCASTER RD
Second Line	:	GASTRO 111B1, DVAMC
City	:	DALLAS
State	:	TX
Zip	:	75216-7167
Country	:	US
Telephone Number	:	214-371-6441
Fax Number	:	214-857-1571

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	07/08/2007

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