Provider Demographics
NPI:1396854170
Name:RESTREPO, WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:RESTREPO
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 1:409 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501
Mailing Address - Country:US
Mailing Address - Phone:956-682-1508
Mailing Address - Fax:956-682-0551
Practice Address - Street 1:409 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-682-1508
Practice Address - Fax:956-682-0551
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8809207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB148540OtherMEDICARE
TX098458502Medicaid
TX098458504Medicaid
TX390004619OtherRAILROAD MEDICARE NO.
TX390004619OtherRAILROAD MEDICARE NO.
00G14TMedicare ID - Type Unspecified