Provider Demographics
NPI:1164965497
Name:ROSS, WILLIAM
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15777 QUORUM DR
Mailing Address - Street 2:1415
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3474
Mailing Address - Country:US
Mailing Address - Phone:972-741-4995
Mailing Address - Fax:
Practice Address - Street 1:15777 QUORUM DR
Practice Address - Street 2:1415
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3474
Practice Address - Country:US
Practice Address - Phone:972-741-4995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management