Willis, Charles E
Willis, Charles E is an individual health care provider with primary practice located at 911 York Dr Ste 205 , Desoto TX 75115-2064. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Willis, Charles E can be contacted via phone (214) 623-0550.Contact Information
Primary practice address
911 York Dr Ste 205
Desoto TX 75115-2064
Phone: (214) 623-0550
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | J0365 | Texas |
Profile Details
| NPI number | 1336142983 |
|---|---|
| LBN Legal business name | Willis, Charles E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2005 |
| Last updated | Feb 10th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336142983 | NPPES |
| Texas | MEDICAID | 134219808 | |
| Texas | Other | 00R03P |
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