Willis, John M
Willis, John M is an individual health care provider with primary practice located at 252 Matlock Rd Ste 130 , Mansfield TX 76063-4295. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Willis, John M can be contacted via phone (682) 242-8990.Contact Information
Primary practice address
252 Matlock Rd Ste 130
Mansfield TX 76063-4295
Phone: (682) 242-8990
Fax: (682) 242-8996
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | J0366 | Texas |
Profile Details
| NPI number | 1205891207 |
|---|---|
| LBN Legal business name | Willis, John M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2006 |
| Last updated | Mar 23rd, 2022 - about 2 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 | 1205891207 | NPPES |
| Texas | MEDICAID | 129827510 | |
| Texas | Other | 8X9688 |
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