Individual
MR. WILLIAM JAMES ELDRIDGE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6610 PALISADES DR, TEXARKANA, TX 75503-4972
(903) 908-4475
Mailing address
6610 PALISADES DR, TEXARKANA, TX 75503-4972
(903) 908-4475
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111200A
—
OK
Enumeration date
12/17/2013
Last updated
12/17/2013
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