Provider Demographics
NPI:1144229659
Name:GEORGE, WILLIAM DEWITT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DEWITT
Last Name:GEORGE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 CALDER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1845
Mailing Address - Country:US
Mailing Address - Phone:409-833-9797
Mailing Address - Fax:409-654-6886
Practice Address - Street 1:2400 HIGHWAY 365
Practice Address - Street 2:SUITE 201
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6249
Practice Address - Country:US
Practice Address - Phone:409-833-9797
Practice Address - Fax:409-654-6816
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2018-09-11
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
TXC8288174400000X, 207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133790915Medicaid
TX8CU673OtherBCBS
TXC16044Medicare UPIN
TX8CU673OtherBCBS
TXTXB125448Medicare PIN