Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 4387 | DC |
NPI | 1235191404 |
---|---|
Provider Name | Dr. William R Hogans III |
First Address | Fort Sam Houston, TX 78234-6230 |
Second Address | Fort Sam Houston, TX 78234-6230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 08/07/2007 |