Stout, William R.

Stout, William R. is an individual health care provider with primary practice located at 4916 Overton Plz , Fort Worth TX 76109-4415. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Stout, William R. can be contacted via phone (888) 804-3000.

Contact Information

Primary practice address
4916 Overton Plz Fort Worth TX 76109-4415
Phone: (888) 804-3000
Fax: (817) 334-0235
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 218844 Texas

Profile Details

NPI number 1275505158
LBN Legal business name Stout, William R.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Sep 25th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275505158 NPPES
Texas MEDICAID 088796005
Texas MEDICAID 169909201

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