Individual
WALTER WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
6836
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09050686
TX DEPT OF PUBLIC SAFETY
TX
Enumeration date
05/18/2012
Last updated
05/18/2012
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