Provider Demographics
NPI:1396852448
Name:LOUIS, WILLIAM GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GEORGE
Last Name:LOUIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2301 SOUTH CLEAR CREEK ROAD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549
Mailing Address - Country:US
Mailing Address - Phone:254-634-1500
Mailing Address - Fax:254-634-7702
Practice Address - Street 1:2301 SOUTH CLEAR CREEK ROAD
Practice Address - Street 2:SUITE 206
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549
Practice Address - Country:US
Practice Address - Phone:254-634-1500
Practice Address - Fax:254-634-7702
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI25842020207V00000X
TXG7137207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115721602Medicaid
C18548Medicare UPIN
TX115721602Medicaid