Provider Demographics
NPI:1619063336
Name:WALDROP, WILLIAM B (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:WALDROP
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 1:6621 FANNIN ST STE W17417
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2372
Mailing Address - Country:US
Mailing Address - Phone:832-824-1000
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2358
Practice Address - Country:US
Practice Address - Phone:832-824-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004014288207L00000X, 207LC0200X, 207LP3000X
TXQ9074207L00000X, 207LP3000X
ARE-16106207L00000X, 207LC0200X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1524631Medicaid
IA1619063336Medicaid
KS200686180AMedicaid
KY7100154120Medicaid
MO101740042Medicaid
MI1619063336Medicaid
MN1819083886Medicaid
AR185884001Medicaid
FL914479000Medicaid
KY7100154120Medicaid
MO101740042Medicare PIN