Individual
DR. WILLIAM T. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8401 DATAPOINT DR STE 600, SAN ANTONIO, TX 78229-5907
(210) 616-7700
(210) 616-7709
Mailing address
8401 DATAPOINT, SUITE 600, P. O. BOX 29441, SAN ANTONIO, TX 78229-0441
(210) 616-7700
(210) 616-7709
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
F4578
TX
2085R0202X
Diagnostic Radiology Physician
Primary
F4578
TX
2085U0001X
Diagnostic Ultrasound Physician
F4578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1345241-08
—
TX
05
—
1345241-09
—
TX
05
—
1345241-10
—
TX
01
—
8L26946
MEDICARE - STRIC
TX
01
—
F4578
TEXAS MEDICAL LICENSE
TX
01
—
P00829954
RAILROAD MEDICARE
TX
01
—
P00845686
RAILROAD MEDICARE
TX
Enumeration date
12/22/2005
Last updated
04/07/2016
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