Provider Demographics
NPI:1760648976
Name:STILES, BILL MARCUS JR (LP, CCP)
Entity Type:Individual
Prefix:MR
First Name:BILL
Middle Name:MARCUS
Last Name:STILES
Suffix:JR
Gender:M
Credentials:LP, CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 FOXGLOVE TRL
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75069-6877
Mailing Address - Country:US
Mailing Address - Phone:214-213-0712
Mailing Address - Fax:972-742-9709
Practice Address - Street 1:895 FOXGLOVE TRL
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TX
Practice Address - Zip Code:75069-6877
Practice Address - Country:US
Practice Address - Phone:214-213-0712
Practice Address - Fax:972-742-9709
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPF0100171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor