Individual
MR. WILLARD LEO MCGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1102 DOVE LN, BURKBURNETT, TX 76354-2860
(940) 569-3399
Mailing address
1102 DOVE LN, BURKBURNETT, TX 76354-2860
(940) 569-3399
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01008
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA01008
LICENSE
TX
Enumeration date
02/26/2007
Last updated
07/08/2007
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