Provider Demographics
NPI:1184666356
Name:THORNTON, WILLIAM R (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:THORNTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2191 NW MILITARY HWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1836
Mailing Address - Country:US
Mailing Address - Phone:210-348-8788
Mailing Address - Fax:210-348-8768
Practice Address - Street 1:2191 NW MILITARY HWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213
Practice Address - Country:US
Practice Address - Phone:210-348-8788
Practice Address - Fax:210-348-8768
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8914207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0087NGOtherBLUE CROSS
TX1782344Medicaid
TXD14337Medicare UPIN
TX1782344Medicaid
TX335805YYCSMedicare PIN