Basic Information
Provider Information
NPI: 1043290083
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOOT
FirstName: WILLIAM
MiddleName: ROLLINS
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 816 W CANNON ST
Address2:  
City: FORT WORTH
State: TX
PostalCode: 761043146
CountryCode: US
TelephoneNumber: 8173210312
FaxNumber: 8173177033
Practice Location
Address1: 816 W CANNON ST
Address2:  
City: FORT WORTH
State: TX
PostalCode: 761043146
CountryCode: US
TelephoneNumber: 8173210312
FaxNumber: 8173177033
Other Information
ProviderEnumerationDate: 01/17/2006
LastUpdateDate: 05/09/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085B0100XE0245TXN Allopathic & Osteopathic PhysiciansRadiologyBody Imaging
2085N0700XE0245TXN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085N0904XE0245TXN Allopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
2085P0229XE0245TXN Allopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
2085R0202XE0245TXY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0204XE0245TXN Allopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
2085U0001XE0245TXN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound

ID Information
IDTypeStateIssuerDescription
E024501TXTX PHYSICIANS PERMITOTHER
12931280505TX MEDICAID


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