Provider Demographics
NPI:1336416510
Name:ROBERT P WILLS MD PLLC
Entity Type:Organization
Organization Name:ROBERT P WILLS MD PLLC
Other - Org Name:AUSTIN PAIN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:WILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-416-7246
Mailing Address - Street 1:2501 W WILLIAM CANNON DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5281
Mailing Address - Country:US
Mailing Address - Phone:512-416-7246
Mailing Address - Fax:512-416-7246
Practice Address - Street 1:2200 PARK BEND DR
Practice Address - Street 2:BLDG 1, SUITE 201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:512-416-7246
Practice Address - Fax:512-275-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6529890002Medicare NSC