Provider Demographics
NPI:1659545937
Name:WILLIAM P ADAMS JR MD PA
Entity Type:Organization
Organization Name:WILLIAM P ADAMS JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:214-965-9885
Mailing Address - Street 1:2801 LEMMON AVE
Mailing Address - Street 2:#300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2356
Mailing Address - Country:US
Mailing Address - Phone:214-965-9885
Mailing Address - Fax:
Practice Address - Street 1:2801 LEMMON AVE
Practice Address - Street 2:#300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2356
Practice Address - Country:US
Practice Address - Phone:214-965-9885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5134261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
G02655Medicare UPIN
8F1804Medicare PIN