Provider Demographics
NPI:1356528046
Name:CLEMENTSON, WILLIAM EVERETT (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EVERETT
Last Name:CLEMENTSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 SHOAL CREEK BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-6809
Mailing Address - Country:US
Mailing Address - Phone:737-212-8181
Mailing Address - Fax:
Practice Address - Street 1:8701 SHOAL CREEK BLVD STE 401
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-6809
Practice Address - Country:US
Practice Address - Phone:737-212-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9689207P00000X
PAOS015053207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine