Provider Demographics
NPI:1649401712
Name:WILLIAM MORAN, M.D., P.A.
Entity Type:Organization
Organization Name:WILLIAM MORAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-459-3205
Mailing Address - Street 1:4201 MARATHON BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3436
Mailing Address - Country:US
Mailing Address - Phone:512-459-3205
Mailing Address - Fax:512-459-8590
Practice Address - Street 1:4201 MARATHON BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3436
Practice Address - Country:US
Practice Address - Phone:512-459-3205
Practice Address - Fax:512-459-8590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC19572Medicare UPIN
TX00DV65Medicare PIN