Provider Demographics
NPI:1558377325
Name:JANSS, WILLIAM C (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:JANSS
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 1:221 N KANSAS ST
Mailing Address - Street 2:STE. 1501
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79901-1443
Mailing Address - Country:US
Mailing Address - Phone:915-546-9200
Mailing Address - Fax:915-546-9800
Practice Address - Street 1:221 N KANSAS ST
Practice Address - Street 2:STE. 1501
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-1443
Practice Address - Country:US
Practice Address - Phone:915-546-9200
Practice Address - Fax:915-546-9800
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4462207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM33632359Medicaid
TXP01251633OtherRAILROAD RETIREMENT MEDICARE
TX1162018-08Medicaid
TX8DZ191OtherBC/BS OF TEXAS
TX8DZ191OtherBC/BS OF TEXAS
TX1162018-08Medicaid
TX116201806Medicaid
TX116201805Medicaid