Provider Demographics
NPI:1902854524
Name:DANIEL, WILLIAM CLIFTON (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLIFTON
Last Name:DANIEL
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:P.O. BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:816-931-1883
Mailing Address - Fax:816-756-3645
Practice Address - Street 1:5323 HARRY HINES BOULEVARD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:469-291-3369
Practice Address - Fax:214-645-0078
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4760207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00842598OtherRAILROAD MEDICARE
KS100333020IMedicaid
KS100333020FMedicaid
MO203948203Medicaid
MOP00836070OtherRAILROAD MEDICARE
KS100333020HMedicaid
MO203948203Medicaid
MOP00836070OtherRAILROAD MEDICARE
MOMA2491049Medicare PIN
KSKA1724009Medicare PIN
KSKA1021034OtherMEDICARE - CUSHING
F77334Medicare UPIN
KS100333020FMedicaid