Provider Demographics
NPI:1578663506
Name:POSNICK, WILLIAM R (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:POSNICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 65TH ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-1864
Mailing Address - Country:US
Mailing Address - Phone:409-744-4551
Mailing Address - Fax:
Practice Address - Street 1:2501 65TH ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-1864
Practice Address - Country:US
Practice Address - Phone:409-744-4551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU25625Medicare UPIN
TX83012NMedicare ID - Type Unspecified