Provider Demographics
NPI:1689733107
Name:HUMENIUK, WILLIAM BARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BARRY
Last Name:HUMENIUK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:W
Other - Middle Name:BARRY
Other - Last Name:HUMENIUK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6045 ALMA RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2188
Mailing Address - Country:US
Mailing Address - Phone:972-931-5437
Mailing Address - Fax:214-427-8411
Practice Address - Street 1:6045 ALMA RD
Practice Address - Street 2:SUITE 340
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2188
Practice Address - Country:US
Practice Address - Phone:972-931-5437
Practice Address - Fax:214-427-8411
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6004207XP3100X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0027DWOtherBLUE CROSS BLUE SHIELD
H03311Medicare UPIN
TX8F9209Medicare PIN