Provider Demographics
NPI:1710985908
Name:HOOPER, WILLIAM R (CRNA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:R
Last Name:HOOPER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:DICK
Other - Middle Name:
Other - Last Name:HOOPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA PC
Mailing Address - Street 1:2394 FM 309
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76645-5241
Mailing Address - Country:US
Mailing Address - Phone:432-553-1061
Mailing Address - Fax:
Practice Address - Street 1:2394 FM 309
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-5241
Practice Address - Country:US
Practice Address - Phone:432-553-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX542725367500000X, 367500000X
IL209-005235367500000X, 367500000X
LARN109350367500000X
SCAPN2030367500000X
GARN169034367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA512159967BMedicaid
GA511I430137Medicare PIN