William Michael Walton, D.D.S
Individual provider Active NPI Dentist · Clyde, TX
NPI 1003020058 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003020058
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 11233 (TX)
- Practice address
- 113 Hunt Street
Clyde, TX 79510 - Phone
- (325) 893-5875
- Fax
- (325) 893-5876
- NPI assigned
- May 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11233 | TX | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11233 | TX | Yes |
Addresses
Primary practice location
113 Hunt Street
Clyde, TX 79510
Mailing address
PO Box 481
113 Hunt
Clyde, TX 79510-0481
Phone (325) 893-5875
Other providers in Clyde, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.