Provider Demographics
NPI:1033490677
Name:HERRITAGE, WILLIAM M II (PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:M
Last Name:HERRITAGE
Suffix:II
Gender:M
Credentials:PT
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Mailing Address - Street 1:2670 FIREWHEEL DR.
Mailing Address - Street 2:STE B
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028
Mailing Address - Country:US
Mailing Address - Phone:972-355-8301
Mailing Address - Fax:972-355-8304
Practice Address - Street 1:724 W MAIN
Practice Address - Street 2:STE 180
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067
Practice Address - Country:US
Practice Address - Phone:972-434-6024
Practice Address - Fax:972-434-2784
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
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Provider Licenses
StateLicense IDTaxonomies
TX1207022225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist