Provider Demographics
NPI:1659451623
Name:KRITZER, WILLIAM CORBIN JR (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CORBIN
Last Name:KRITZER
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2816 SHASTA DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-4100
Mailing Address - Country:US
Mailing Address - Phone:972-727-5501
Mailing Address - Fax:
Practice Address - Street 1:321 N ALLEN DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2539
Practice Address - Country:US
Practice Address - Phone:972-727-5717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3810TG152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093398803Medicaid
TX0223320001Medicare NSC
TX093398803Medicaid
TXTXB152283Medicare PIN
TXT14270Medicare UPIN