MEDICARE: MR. WILLIAM JAMES TINNELL DDS

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	1223G0001X	General Practice Dentistry	14822	TX

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	666787	OTHER	TX	UNITED CONCORDIA

General Provider Information

NPI Number	:	1982777660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM JAMES TINNELL DDS

Provider Business Mailing Address
First Line	:	PO BOX 339
Second Line	:
City	:	FALFURRIAS
State	:	TX
Zip	:	78355
Country	:	US
Telephone Number	:	361-325-4288
Fax Number	:	361-325-5746

Provider Business Practice Location Address
First Line	:	129 N LAS PITAS ST
Second Line	:
City	:	FALFURRIAS
State	:	TX
Zip	:	78355-3609
Country	:	US
Telephone Number	:	361-325-4288
Fax Number	:	361-325-5746

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	10/28/2022

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