Provider Demographics
NPI:1255340626
Name:POWELL, WILLIAM CAMERON (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CAMERON
Last Name:POWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8715 VILLAGE DR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5405
Mailing Address - Country:US
Mailing Address - Phone:210-653-5501
Mailing Address - Fax:210-653-8137
Practice Address - Street 1:8715 VILLAGE DR
Practice Address - Street 2:SUITE 410
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5405
Practice Address - Country:US
Practice Address - Phone:210-653-5501
Practice Address - Fax:210-653-8137
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3439207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH91054Medicare UPIN
TX8A9370Medicare ID - Type Unspecified