Provider Demographics
NPI:1306950597
Name:HASKETT, WILLIAM RICHARD (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RICHARD
Last Name:HASKETT
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 1:405 LONDONDERRY DR STE 312
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7922
Mailing Address - Country:US
Mailing Address - Phone:254-776-4961
Mailing Address - Fax:254-776-4964
Practice Address - Street 1:405 LONDONDERRY DR STE 312
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7922
Practice Address - Country:US
Practice Address - Phone:254-776-4961
Practice Address - Fax:254-776-4964
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6279207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122854606Medicaid
TX8C0858Medicare ID - Type Unspecified
TX122854606Medicaid