Individual
WILLIAM RICHARD VANDIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
108 E. US HWY HWY 80 SUITE 150, FORNEY, TX 75126-8703
(972) 564-4444
(833) 320-1559
Mailing address
108 E US HIGHWAY 80 STE 150, FORNEY, TX 75126-8703
(972) 564-4444
(833) 320-1559
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
K9195
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040025101
—
TX
01
—
82V196
BCBS
TX
Enumeration date
06/12/2006
Last updated
08/21/2023
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