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Individual

WILLIAM WORTHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2391 NE LOOP 410, STE 405, SAN ANTONIO, TX 78217-5600
(210) 654-7326
(210) 590-8232
Mailing address
7142 SAN PEDRO AVE, SUITE 120, SAN ANTONIO, TX 78216-6254
(210) 661-5622
(210) 590-8232

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
J1063
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
045109801
TX
01
390004831
MEDICARE RAILROAD
TX
Enumeration date
12/13/2005
Last updated
07/30/2009
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