Provider Demographics
NPI:1710997127
Name:SHEEHAN, WILLIAM LUTHER (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LUTHER
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 COUNTY ROAD 3271 W
Mailing Address - Street 2:
Mailing Address - City:MOUNT ENTERPRISE
Mailing Address - State:TX
Mailing Address - Zip Code:75681-6835
Mailing Address - Country:US
Mailing Address - Phone:903-822-3061
Mailing Address - Fax:903-822-3033
Practice Address - Street 1:1737 COUNTY ROAD 3271 W
Practice Address - Street 2:
Practice Address - City:MOUNT ENTERPRISE
Practice Address - State:TX
Practice Address - Zip Code:75681-6835
Practice Address - Country:US
Practice Address - Phone:903-822-3061
Practice Address - Fax:903-822-3033
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC 8435208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC918Medicare ID - Type Unspecified
TXC21701Medicare UPIN