Provider Demographics
NPI:1720064900
Name:STRUTHERS, WILLIAM BURTON (M D)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BURTON
Last Name:STRUTHERS
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:6606 LBJ FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6968207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138495002Medicaid
TX138495018Medicaid
TXP01447029OtherRR
TXP08628J28Medicaid
TX8EH528OtherBCBS
TX8533J2Medicare PIN
TX8628J2Medicare PIN
TXP01447029OtherRR
TXP08628J28Medicaid
TX138495017Medicaid
TXTXB134888Medicare PIN
TX138495016OtherMEDICAID CSHCN
TXP08628J28Medicaid
E23861Medicare UPIN