Provider Demographics
NPI:1548233695
Name:BISHOP, WILLIAM EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:EUGENE
Last Name:BISHOP
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:PO BOX 17916
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1034
Mailing Address - Country:US
Mailing Address - Phone:888-896-9369
Mailing Address - Fax:775-852-6902
Practice Address - Street 1:218 QUINLAN ST # 372
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5314
Practice Address - Country:US
Practice Address - Phone:830-997-1268
Practice Address - Fax:775-852-6902
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE83332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137757403Medicaid
TX85267RMedicare PIN
E02155Medicare UPIN