Willis, Shaun

Willis, Shaun is an sole proprietor health care provider with primary practice located at 1108 N Mechanic St , El Campo TX 77437. He recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Willis, Shaun can be contacted via phone (979) 541-5400.

Contact Information

Primary practice address
1108 N Mechanic St El Campo TX 77437
Phone: (979) 541-5400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 27076 Texas
Dental Providers / General Practice 1223G0001X 27076 Texas

Profile Details

NPI number 1942597976
LBN Legal business name Willis, Shaun
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2011
Last updated Oct 15th, 2018 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1942597976 NPPES
Texas Other 27076 TEXAS DENTAL LICENSE

Popular Providers