Provider Demographics
NPI:1619255353
Name:MCCANN, WILLIAM R (R EP T)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:MCCANN
Suffix:
Gender:M
Credentials:R EP T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 TOWN SQUARE PL
Mailing Address - Street 2:SUITE 290
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1465
Mailing Address - Country:US
Mailing Address - Phone:281-768-6730
Mailing Address - Fax:281-768-6766
Practice Address - Street 1:2150 TOWN SQUARE PL
Practice Address - Street 2:SUITE 290
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1465
Practice Address - Country:US
Practice Address - Phone:281-768-6730
Practice Address - Fax:281-768-6766
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R. EP T. 1087246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
1087OtherR. EP T.