Provider Demographics
NPI:1255323861
Name:WALTON, WILLIAM JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAMES
Last Name:WALTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9601 WHITE ROCK TRL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-5011
Mailing Address - Country:US
Mailing Address - Phone:214-349-3646
Mailing Address - Fax:214-349-1841
Practice Address - Street 1:9601 WHITE ROCK TRL
Practice Address - Street 2:SUITE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-5011
Practice Address - Country:US
Practice Address - Phone:214-349-3646
Practice Address - Fax:214-349-1841
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF0813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000127392OtherAETNA I D
TX4587898OtherCIGNA ID #
TX0067GHOtherBLUE CROSS OF TX I D NUMB
TX098359503Medicaid
TX0067GHOtherBLUE CROSS OF TX I D NUMB
TX098359503Medicaid