Provider Demographics
NPI:1588673891
Name:NELSON, WILLIAM JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:NELSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6416 BANDERA RD STE B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1511
Mailing Address - Country:US
Mailing Address - Phone:210-681-1000
Mailing Address - Fax:210-680-9921
Practice Address - Street 1:6416 BANDERA RD STE B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1511
Practice Address - Country:US
Practice Address - Phone:210-681-1000
Practice Address - Fax:210-680-9921
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601851Medicare PIN