Provider Demographics
NPI:1497069447
Name:W.H.LANDERS, JR., M.D., PLLC
Entity Type:Organization
Organization Name:W.H.LANDERS, JR., M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILSON
Authorized Official - Middle Name:HARRY
Authorized Official - Last Name:LANDERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:806-274-3645
Mailing Address - Street 1:200 S MCGEE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79007-4022
Mailing Address - Country:US
Mailing Address - Phone:806-274-3645
Mailing Address - Fax:806-273-1402
Practice Address - Street 1:200 S MCGEE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4022
Practice Address - Country:US
Practice Address - Phone:806-274-3645
Practice Address - Fax:806-273-1402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF 1728207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty