Provider Demographics
NPI:1639204001
Name:CANADA, WILLIAM H (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:CANADA
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 1:5656 BEE CAVE RD STE E201
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5035
Mailing Address - Country:US
Mailing Address - Phone:512-732-9909
Mailing Address - Fax:512-329-8890
Practice Address - Street 1:5656 BEE CAVE RD STE E201
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5035
Practice Address - Country:US
Practice Address - Phone:512-732-9909
Practice Address - Fax:512-329-8890
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC9398174400000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC9398OtherMEDICAL LICENSE
TXC9398OtherMEDICAL LICENSE