Provider Demographics
NPI:1447233465
Name:GATES, WILLIAM BRADLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRADLEY
Last Name:GATES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3108 MIDWAY RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6114
Mailing Address - Country:US
Mailing Address - Phone:972-801-9100
Mailing Address - Fax:972-378-4846
Practice Address - Street 1:3108 MIDWAY RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6114
Practice Address - Country:US
Practice Address - Phone:972-801-9100
Practice Address - Fax:972-378-4846
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5106207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S3380OtherBCBS PROVIDER #
TX8S3380OtherBCBS PROVIDER #