NPIMap

Individual provider Active NPI

William Russell Giles Jr., MD

  • Internal Medicine Physician
  • Gun Barrel City, TX
National Provider Identifier
1386662419
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M0730 Issued in TX
Practice address
126 W Main St
Gun Barrel City, TX 75156-5297
Phone
(903) 713-1582
Fax
(903) 713-1579
NPI assigned
Jul 17, 2006
Last updated
Jan 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M0730 TX Primary

Addresses

Primary practice location

126 W Main St
Gun Barrel City, TX 75156-5297

Mailing address

PO Box 9477
Tyler, TX 75711-9477
Phone (903) 713-1582

Other identifiers 3

IdentifierTypeStateIssuer
8S5838OtherTXBLUE CROSS
P00339673OtherTXRAILROAD MEDICARE
174192802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050421001170 TX Practitioner - Internal MedicinePractitioner - Emergency Medicine 3173561974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
University of Texas Medical School at Houston, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

100 Municipal Dr
Suite 300
Gun Barrel City, TX 75156-3703
Phone (903) 713-1574

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
East Texas Medical Center Healthcare Associates Past Accepting new patients

Locations

340 Seven Springs Way
Ste 100
Brentwood, TN 37027
Phone (615) 296-3000

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

100 Municipal Dr
Ste 300
Gun Barrel City, TX 75156
Phone (903) 713-1500

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

Interoperability endpoints

  • Direct secure messaging: wgiles355227@ahs.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1386662419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9477",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757119477",
            "telephone_number": "903-713-1582",
            "fax_number": "903-713-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 W MAIN ST",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751565297",
            "telephone_number": "903-713-1582",
            "fax_number": "903-713-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILES",
        "first_name": "WILLIAM",
        "middle_name": "RUSSELL",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M0730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8S5838",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00339673",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174192802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gun Barrel City, TX

Sources for this page

Verify at the official NPI Registry.