Charles E. Willis II, M.D., P.a.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

J0365 Issued in TX

Legal business name

CHARLES E. WILLIS II, M.D., P.A.

Practice address

5201 S Westmoreland Rd
Dallas, TX 75237-1622

Phone

(214) 623-0550

NPI assigned

Feb 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charles E. Willis II, M.D.NPI 1336142983

Title

President

Phone

(214) 623-0550

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles E Willis, MD

  • Pain Medicine Physician
  • Desoto, TX
  • NPI 1336142983

  Pain Medicine, TX

  Medicare reassignment NPD Authorized official
• Felicia M. Cooks, CRNA

  • Certified Registered Nurse Anesthetist
  • Arlington, TX
  • NPI 1922012020
  NPD (past)
• William Cornelius Love, DC

  • Chiropractor
  • Desoto, TX
  • NPI 1457161531
  NPD (past)
• Charles E Walker, DC

  • Chiropractor
  • Harker Heights, TX
  • NPI 1265244529
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210377600000",
    "number": "1295862431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1347",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750011347",
            "telephone_number": "972-991-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 S WESTMORELAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752371622",
            "telephone_number": "214-623-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES E. WILLIS II, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-05-10",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-623-0550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "J0365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00R03P",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162314201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charity Comfort Care Medical Supplies
• Charity Comfort Care Services. LLC
• Camille Charlery, LPC
• Charles a Iliya MD PA
• Charles B Shuey Jr MD PA
• Charles Edward McGriff
• Charles H Dukes M.D., P.a.
• Charles J. Lostak, D.O., P.a.
• Charles N. Rubey, M.D.,P.a.
• Charles P. Guerriero III, MD

• Pain Medicine (Anesthesiology) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pain Medicine (Anesthesiology) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.

Verify at the official NPI Registry.