Individual provider Active NPI

William Tanner, P.A.

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1467904797
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10941 Issued in TX
Practice address
6701 Fannin St
Houston, TX 77030-2608
Phone
(832) 824-1000
NPI assigned
Nov 3, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA10941 TX Primary

Addresses

Primary practice location

6701 Fannin St
Houston, TX 77030-2608

Mailing address

2 Greenway PLZ
Suite 300
Houston, TX 77046-0297
Phone (832) 828-3660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200127001090 TX Practitioner - Physician Assistant 6901231638 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10941TXMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: wtanner63575@prddirect.texaschildrens.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1467904797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GREENWAY PLZ",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460297",
            "telephone_number": "832-828-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302608",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "WILLIAM",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA10941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.