Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | L9773 | TX |
N | 207PE0004X | Emergency Medical Services | L9773 | TX |
Y | 208000000X | Pediatrician | L9773 | TX |
NPI | 1063477412 |
---|---|
Provider Name | Prof. William T Langston JR. |
First Address | San Antonio, TX 78207-3108 |
Second Address | San Antonio, TX 78207-3108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 20/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
164025202 | (05) | TX |
H87745 | (02) | TX |