William C. Boostrom is a Medical in Irving, Texas. William C. Boostrom practices all healthcare services and medical treatments related to Medical. The NPI Number for William C. Boostrom is 1760475933. The last update date is 2021-04-14.
William C. Boostrom's current location address is 919 Hidden Rdg, Irving, Texas. You can contact this provider via phone number 4692822713 and fax number 4692822609. The mailing address for William C. Boostrom is 919 Hidden Rdg, Irving, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | William C. Boostrom |
|---|---|
| Address | 919 Hidden Rdg, Irving, Texas |
| Phone Number | 4692822713 |
| Fax Number | 4692822609 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1760475933 |
|---|---|
| Provider Enumeration Date | 2005-08-23 |
| Last Updated Date | 2021-04-14 |
Provider Mailing Address Detail
| Address | 919 Hidden Rdg |
|---|---|
| City | Irving |
| State | Texas (TX) |
| Post Code | 750383813 |
| Phone Number | 4692822713 |
| Fax Number | 4692822609 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA00623 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 345976001 | TX | -- | |
| 1L4734 | TX | MEDICARE | |
| P02601724 | TX | MCRR |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to William C. Boostrom by the Centers for Medicare & Medicaid Services?
The William C. Boostrom has been issued the NPI (National Provider Identifier) 1760475933, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of William C. Boostrom?
The William C. Boostrom is situated at 919 Hidden Rdg, in the city of Irving, state of TX, with the zip code 750383813.
What is the area of specialization for William C. Boostrom, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for William C. Boostrom is Medical, and the corresponding taxonomy code that categorizes this area of expertise is 363Am0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1760475933 to William C. Boostrom?
The William C. Boostrom received its 1760475933 assignment from the Centers for Medicare & Medicaid Services on 2005-08-23.
As of what date were the details pertaining to William C. Boostrom last refreshed?
The information related to the William C. Boostrom, including its address, specialty, and other relevant details, was last updated on 2021-04-14.