Organization Name: | ROBERT P WILLS MD PLLC |
NPI Number: | 1194112540 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT P. WILLS (PRESIDENT) |
Mailing Address: | 14008 Shadow Glen Blvd Suite 200 Manor |
State: | TX US |
Postal Code: | 786533396 |
Phone Number: | 5124167246 |
Fax Number: | 5122752833 |
NPI Enumeration Date: | 04/23/2015 |
NPI Last Update Date: | 12/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |