Willis, Brian Keith

Willis, Brian Keith is an individual health care provider with primary practice located at 1002 Texas Blvd Ste 406 , Texarkana TX 75501-5113. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Willis, Brian Keith can be contacted via phone (903) 794-4196.

Contact Information

Primary practice address
1002 Texas Blvd Ste 406 Texarkana TX 75501-5113
Phone: (903) 794-4196
Fax: (903) 792-7408
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 016892 Louisiana
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X P9030 Texas

Profile Details

NPI number 1821014648
LBN Legal business name Willis, Brian Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Feb 24th, 2014 - about 11 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 1821014648 NPPES
Louisiana MEDICAID 1936936

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