Provider Demographics
NPI:1770898306
Name:MUSGRAVE, WILLIAM L (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:MUSGRAVE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1750 KELLER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3704
Mailing Address - Country:US
Mailing Address - Phone:817-310-9510
Mailing Address - Fax:817-310-9513
Practice Address - Street 1:1750 KELLER PARKWAY
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3704
Practice Address - Country:US
Practice Address - Phone:817-310-9510
Practice Address - Fax:817-310-9513
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2019-08-19
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Provider Licenses
StateLicense IDTaxonomies
TXP5850207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T83UMedicare UPIN