Provider Demographics
NPI:1326058850
Name:DEFOYD, WILLIAM D (D C)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:DEFOYD
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 CYPRESS PT E
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7248
Mailing Address - Country:US
Mailing Address - Phone:512-345-5925
Mailing Address - Fax:512-343-7113
Practice Address - Street 1:4029 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:SUITE 111
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7927
Practice Address - Country:US
Practice Address - Phone:512-345-5925
Practice Address - Fax:512-343-7113
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82T271Medicare ID - Type UnspecifiedMEDICARE NUMBER
TXT12975Medicare UPIN