Provider Demographics
NPI:1356445647
Name:RISHEL, WILLIAM D (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:RISHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-2123
Mailing Address - Country:US
Mailing Address - Phone:903-592-2122
Mailing Address - Fax:903-595-2280
Practice Address - Street 1:1130 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2123
Practice Address - Country:US
Practice Address - Phone:903-592-2122
Practice Address - Fax:903-595-2280
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2726208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOOB03EMedicaid
TXF37691Medicare UPIN