Individual
BILLY B WESTBROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2828 N FOURTH ST, SUITE 200, LONGVIEW, TX 75605-5718
(903) 758-4468
(903) 758-5056
Mailing address
2828 N 4TH ST, LONGVIEW, TX 75605-5718
(903) 758-4468
(903) 758-5056
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
TX0578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092751901
—
TX
05
—
092751902
—
TX
01
—
480001643
MEDICARE RAILROAD
TX
01
—
480928621
MEDICARE RAILROAD
TX
01
—
751523800
IRS INDIVIDUAL TAXPAYER IDENTIFICATION NUMBER
TX
01
—
8AJ312
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/13/2006
Last updated
09/17/2024
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