Organization
WILLIAM J. VAN WYK M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM J. VAN WYK M.D., P.A. (PRESIDENT)
(817) 877-3113
Entity
Organization
Contact information
Practice address
803 W TERRELL AVE, FORT WORTH, TX 76104-3155
(817) 877-3113
(817) 877-0022
Mailing address
803 W TERRELL AVE, FORT WORTH, TX 76104-3155
(817) 877-3113
(817) 877-0022
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
D9696
TX
Other
Enumeration date
02/13/2008
Last updated
02/16/2011
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