Provider Demographics
NPI:1982878195
Name:KOECK, WILLIAM KARL (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KARL
Last Name:KOECK
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 1:18626 HARDY OAK BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4210
Mailing Address - Country:US
Mailing Address - Phone:210-497-4186
Mailing Address - Fax:210-497-4718
Practice Address - Street 1:18626 HARDY OAK BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4210
Practice Address - Country:US
Practice Address - Phone:210-497-4186
Practice Address - Fax:210-497-4718
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9423207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199743903Medicaid
TX199743902Medicaid
TX199743904Medicaid
TX199743901Medicaid
TX8L11156Medicare PIN
TX199743901Medicaid