Provider Demographics
NPI:1295980100
Name:WILLIAM B. PURCELL O.D.
Entity type:Organization
Organization Name:WILLIAM B. PURCELL O.D.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BURKS
Authorized Official - Last Name:PURCELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-508-3473
Mailing Address - Street 1:1007 JIM HOGG RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-1901
Mailing Address - Country:US
Mailing Address - Phone:512-508-3473
Mailing Address - Fax:
Practice Address - Street 1:MAIN PX, CLEAR CREEK RD.
Practice Address - Street 2:BLDG. 50004
Practice Address - City:FT. HOOD
Practice Address - State:TX
Practice Address - Zip Code:76545
Practice Address - Country:US
Practice Address - Phone:254-285-2038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3838T152WP0200X, 152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty