Provider Demographics
NPI:1952712853
Name:SHEPARD, WILLIAM DUNCAN (DDS, MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DUNCAN
Last Name:SHEPARD
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 FONDREN RD STE 320
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2320
Mailing Address - Country:US
Mailing Address - Phone:713-783-5560
Mailing Address - Fax:
Practice Address - Street 1:2450 FONDREN RD STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2320
Practice Address - Country:US
Practice Address - Phone:713-783-5560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350391223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery