Provider Demographics
NPI:1215939780
Name:CHRISTENSEN, WILLIAM ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1269
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:75686-2202
Mailing Address - Country:US
Mailing Address - Phone:903-856-6578
Mailing Address - Fax:903-856-6323
Practice Address - Street 1:2701 HWY 271 NORTH
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:TX
Practice Address - Zip Code:75686-1032
Practice Address - Country:US
Practice Address - Phone:903-856-6578
Practice Address - Fax:903-856-6323
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD4953207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120464601Medicaid
TX120464601Medicaid
TXC1447Medicare UPIN