Individual
DR. WILLIAM ARTHUR FAWCETT IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2965 HARRISON ST, SUITE 315, BEAUMONT, TX 77702-1100
(409) 892-7090
(409) 892-4324
Mailing address
2965 HARRISON ST, SUITE 315, BEAUMONT, TX 77702-1100
(409) 892-7090
(409) 892-4324
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
F0998
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00EX91
BLUE CROSS/BLUE SHIELD
TX
05
—
120589005
—
TX
Enumeration date
02/08/2006
Last updated
12/22/2009
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