Willis, Dan A
Willis, Dan A is an sole proprietor health care provider with primary practice located at 1000 9Th Ave Ste. B, Fort Worth TX 76104-3906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Willis, Dan A can be contacted via phone (817) 877-5381.Contact Information
Primary practice address
1000 9Th Ave Ste. B
Fort Worth TX 76104-3906
Phone: (817) 877-5381
Fax: (817) 877-3992
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | E2944 | Texas |
Profile Details
| NPI number | 1497792089 |
|---|---|
| LBN Legal business name | Willis, Dan A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2006 |
| Last updated | Jun 16th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497792089 | NPPES |
| Texas | MEDICAID | 113953703 | |
| Texas | MEDICAID | 113953701 |
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