MEDICARE: WILLIAM DUNCAN SHEPARD DDS, MD

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	35039	TX

General Provider Information

NPI Number	:	1952712853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM DUNCAN SHEPARD DDS, MD

Provider Business Mailing Address
First Line	:	2450 FONDREN RD STE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2320
Country	:	US
Telephone Number	:	713-783-5560
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 FONDREN RD STE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2320
Country	:	US
Telephone Number	:	713-783-5560
Fax Number	:

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

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	07/08/2020

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