Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G0497 | TX |
NPI | 1013024512 |
---|---|
Provider Name | Dr. William C Newberry |
First Address | Corpus Christi, TX 78411-1873 |
Second Address | Corpus Christi, TX 78411-1873 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 04/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
120317604 | (05) | TX |
120317605 | (05) | TX |
180026723 | RR MEDICARE (01) | TX |
B25143 | (02) | TX |
P01024768 | RR MEDICARE (01) | TX |