Provider Demographics
NPI:1942202791
Name:SORRELS, BILL FRANKLIN (DO)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:FRANKLIN
Last Name:SORRELS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:FRANKLIN
Other - Last Name:SORRELS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:4110 HUNTINGTON LANE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904
Mailing Address - Country:US
Mailing Address - Phone:325-212-8865
Mailing Address - Fax:
Practice Address - Street 1:12 EAST TWOHIG
Practice Address - Street 2:STE 200
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-6433
Practice Address - Country:US
Practice Address - Phone:325-340-9899
Practice Address - Fax:210-892-0080
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7187208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2069015Medicaid
TX11604802Medicaid