Provider Demographics
NPI:1568465193
Name:WHITEHEAD, WILLIAM E (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:WHITEHEAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6621 FANNIN ST
Mailing Address - Street 2:CLINICAL CARE CENTER 1230.01
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2303
Mailing Address - Country:US
Mailing Address - Phone:832-822-1282
Mailing Address - Fax:713-796-9636
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:CLINICAL CARE CENTER 1230.01
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2303
Practice Address - Country:US
Practice Address - Phone:832-822-1282
Practice Address - Fax:713-796-9636
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2008-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM7755207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185630401Medicaid
TXH68117Medicare UPIN
TX185630401Medicaid