Provider Demographics
NPI:1649400078
Name:W PADILLA AND ASSOCIATES PA
Entity Type:Organization
Organization Name:W PADILLA AND ASSOCIATES PA
Other - Org Name:G PADILLA MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-224-0555
Mailing Address - Street 1:2502 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-1523
Mailing Address - Country:US
Mailing Address - Phone:713-224-0555
Mailing Address - Fax:713-224-1918
Practice Address - Street 1:2502 CANAL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77003-1523
Practice Address - Country:US
Practice Address - Phone:713-224-0555
Practice Address - Fax:713-224-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X
207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A430910Medicaid
TX286764YKQEMedicare PIN
CA00A430910Medicaid