WILLIAM J. VAN WYK M.D. P.A. NPI 1073781050

NPI Information

WILLIAM J. VAN WYK M.D., P.A. is a medical specialty clinic center in Fort Worth, TX. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). WILLIAM J. VAN WYK M.D., P.A. NPI is 1073781050. The provider is registered as an organization entity type.

The provider's business location address is:

803 W TERRELL AVE
FORT WORTH, TX
ZIP 76104-155
Phone: (817) 877-3113
Fax: (817) 877-0022

The provider's authorized official is William J. Van Wyk .
The authorized official title is President and has the following contact phone number (817) 877-3113.

The enumeration date for this NPI number is 2/13/2008 and was last updated on 2/16/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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