Provider Demographics
NPI:1366483349
Name:HYDE, WILLIAM HAROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HAROLD
Last Name:HYDE
Suffix:
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 1:1706 CRESTED BUTTE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7610
Mailing Address - Country:US
Mailing Address - Phone:512-324-0000
Mailing Address - Fax:512-324-0613
Practice Address - Street 1:4900 MUELLER BLVD
Practice Address - Street 2:NICU 4B062
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3079
Practice Address - Country:US
Practice Address - Phone:512-324-0000
Practice Address - Fax:512-324-0613
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6310174400000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE80411Medicare UPIN