Provider Demographics
NPI:1740287051
Name:TORKILDSEN, WILLIAM H (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:TORKILDSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PORT ISABEL
Mailing Address - State:TX
Mailing Address - Zip Code:78578-4100
Mailing Address - Country:US
Mailing Address - Phone:956-943-1774
Mailing Address - Fax:956-943-7938
Practice Address - Street 1:202 2ND ST
Practice Address - Street 2:
Practice Address - City:PORT ISABEL
Practice Address - State:TX
Practice Address - Zip Code:78578
Practice Address - Country:US
Practice Address - Phone:956-943-1774
Practice Address - Fax:956-943-7938
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2903207RC0000X, 207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133844408Medicaid
TX133844410Medicaid
TXTXB138748Medicare PIN
TX133844410Medicaid