Provider Demographics
NPI:1801128061
Name:METZGER, WILLIAM C (PA-C)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:METZGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MEDICAL DR
Mailing Address - Street 2:STE 104
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3102
Mailing Address - Country:US
Mailing Address - Phone:361-578-7703
Mailing Address - Fax:361-578-7719
Practice Address - Street 1:115 MEDICAL DR
Practice Address - Street 2:STE 104
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3102
Practice Address - Country:US
Practice Address - Phone:361-578-7703
Practice Address - Fax:361-578-7713
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB106891Medicare PIN