Provider Demographics
NPI:1952314908
Name:PEPER, WILLIAM A (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:PEPER
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 1:1000 W STATE HIGHWAY 6 STE 420
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3793
Mailing Address - Country:US
Mailing Address - Phone:254-751-1700
Mailing Address - Fax:254-751-0700
Practice Address - Street 1:1000 W STATE HIGHWAY 6 STE 420
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712
Practice Address - Country:US
Practice Address - Phone:254-751-1700
Practice Address - Fax:254-751-0700
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7043174400000X, 2086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8BF121OtherBC BS IND.
TX159610802Medicaid
TX8F0351OtherMEDICARE PTAN
TXF7043OtherTX LIC.