Provider Demographics
NPI:1912197450
Name:WILLIAM L PHELPS
Entity type:Organization
Organization Name:WILLIAM L PHELPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:PHELPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-328-3597
Mailing Address - Street 1:10611 GARLAND RD
Mailing Address - Street 2:217
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-4801
Mailing Address - Country:US
Mailing Address - Phone:214-328-3597
Mailing Address - Fax:214-324-4893
Practice Address - Street 1:10611 GARLAND RD
Practice Address - Street 2:217
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-4801
Practice Address - Country:US
Practice Address - Phone:214-328-3597
Practice Address - Fax:214-324-4893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2289207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty