Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 17484 | TX |
NPI | 1003831116 |
---|---|
Provider Name | Dr. William Burton Haley, Ii |
First Address | Corpus Christi, TX 78414-3421 |
Second Address | Corpus Christi, TX 78414-3421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 09/07/2007 |