Provider Demographics
NPI:1013024512
Name:NEWBERRY, WILLIAM C (MD, PA)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:NEWBERRY
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3301 S ALAMEDA ST STE 403
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1873
Mailing Address - Country:US
Mailing Address - Phone:361-853-7319
Mailing Address - Fax:361-853-1641
Practice Address - Street 1:3301 S ALAMEDA ST STE 403
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1873
Practice Address - Country:US
Practice Address - Phone:361-853-7319
Practice Address - Fax:361-853-1641
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG0497207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180026723OtherRR MEDICARE
TX120317605Medicaid
TX120317604Medicaid
TXP01024768OtherRR MEDICARE
TXP01024768OtherRR MEDICARE
TX120317605Medicaid