Organization
W. DARRELL WILLERSON JR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DARRELL WILLERSON JR. MD (PRESIDENT)
(210) 271-7648
Entity
Organization
Contact information
Practice address
303 E QUINCY ST STE 100, SAN ANTONIO, TX 78215-1922
(210) 271-7648
(210) 225-8184
Mailing address
303 E QUINCY ST, SUITE 100, SAN ANTONIO, TX 78215-1918
(210) 271-7648
(210) 225-8184
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026NC
BCBS
TX
05
—
177370701
—
TX
Enumeration date
11/17/2006
Last updated
01/15/2013
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