Provider Demographics
NPI:1205834025
Name:SCOTT, WILLIAM E (PA-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:E
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:415 EMBASSY OAKS
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2040
Mailing Address - Country:US
Mailing Address - Phone:210-490-9087
Mailing Address - Fax:210-490-9111
Practice Address - Street 1:415 EMBASSY OAKS
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2040
Practice Address - Country:US
Practice Address - Phone:210-490-9087
Practice Address - Fax:210-490-9111
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA00631363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB154069OtherWELLMED MEDICARE
TXPA00631OtherTX PA LICENSE
TX3131724-01OtherWELLMED MEDICAID