Provider Demographics
NPI:1073077434
Name:DICK, WILLIAM EARL III (LAC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:EARL
Last Name:DICK
Suffix:III
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13370 TRAIL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3751
Mailing Address - Country:US
Mailing Address - Phone:832-338-2405
Mailing Address - Fax:
Practice Address - Street 1:710 ELECTRA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-3703
Practice Address - Country:US
Practice Address - Phone:832-338-2405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01252171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist