Provider Demographics
NPI:1356738488
Name:WILLIS SENIOR HOUSECALLS PLLC
Entity type:Organization
Organization Name:WILLIS SENIOR HOUSECALLS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:214-491-7100
Mailing Address - Street 1:275 HOLDER TRL
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-4133
Mailing Address - Country:US
Mailing Address - Phone:214-491-4191
Mailing Address - Fax:469-519-0407
Practice Address - Street 1:275 HOLDER TRL
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-4133
Practice Address - Country:US
Practice Address - Phone:214-491-4191
Practice Address - Fax:469-519-0407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115180363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty