Provider Demographics
NPI:1396763611
Name:HAWKINS, WILLIE JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIE
Middle Name:JAMES
Last Name:HAWKINS
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 1:7457 HARWIN DR.
Mailing Address - Street 2:SUITE 115
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:713-882-5926
Mailing Address - Fax:281-778-9862
Practice Address - Street 1:3815 N VIRKUS CT
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459
Practice Address - Country:US
Practice Address - Phone:713-882-5926
Practice Address - Fax:281-778-9862
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2147207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB108889OtherPTAN
TXTXB108889OtherPTAN
TX00539XMedicare PIN
TXC16712Medicare UPIN