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Individual
DR. WILLIAM G DOVER
Active
Individual
DR. WILLIAM G DOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02097T
TX
152WC0802X
Corneal and Contact Management Optometrist
02097T
TX
152WP0200X
Pediatric Optometrist
02097T
TX
152WS0006X
Sports Vision Optometrist
02097T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E52G
GROUP BCBS NUMBER
TX
05
—
019709702
—
TX
01
—
021948
BLOCK MEDICAID LOC #
TX
05
—
176941602
—
TX
01
—
80315E
INDIVIDUAL BCBS NUMBER
TX
01
—
921410
BLOCK MEDICAID NUMBER
TX
Enumeration date
12/17/2006
Last updated
05/12/2017
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