MEDICARE: WILLIAM D PICKARD 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	207Q00000X	Family Medicine Physician	G3693	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	1K1988	OTHER	TX	MEDICARE
4	P0000525	OTHER	TX	MEDICARE RAILROAD

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
2	P02601525	OTHER	TX	MCRR
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922001882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM D PICKARD M.D.

Provider Business Mailing Address
First Line	:	919 HIDDEN RDG
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-3813
Country	:	US
Telephone Number	:	469-282-2711
Fax Number	:	469-282-0996

Provider Business Practice Location Address
First Line	:	8445 MEMORIAL BLVD
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77640-7003
Country	:	US
Telephone Number	:	409-982-6461
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	04/14/2021

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Directions to “ WILLIAM D PICKARD M.D.” Practice Location

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