Active NPI
George Willeford III, M.D.
- Gastroenterology Physician
- Austin, TX
National Provider Identifier
1225013758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- E4764
- Practice address
- 1111 W 34TH St
Suite 200
Austin, TX 78705-1900 - Phone
- (512) 454-4588
- Fax
- (512) 459-9869
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | E4764 | TX | Primary |
Addresses
Primary practice location
1111 W 34TH St
Suite 200
Austin, TX 78705-1900
Mailing address
PO Box 10597
Austin, TX 78766-1597
Phone (512) 485-5878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091130000233 | TX | Practitioner - Gastroenterology | 2567409212 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203984000000",
"number": "1225013758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10597",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787661597",
"telephone_number": "512-485-5878",
"fax_number": "512-420-0397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 W 34TH ST",
"address_2": "SUITE 200",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051900",
"telephone_number": "512-454-4588",
"fax_number": "512-459-9869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLEFORD",
"first_name": "GEORGE",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-07",
"last_updated": "2008-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TX",
"license": "E4764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.