DR. WILLIAM C PEDERSON M.D.
NPI 1053387902
Surgery - Plastic and Reconstructive Surgery in Houston, TX

Active since February 28, 2006PECOS EnrolledAccepts Medicare Assignment
1977 BUTLER BLVD STE E6100, HOUSTON, TX 77030(713) 798-6141 Get Directions Write a Review

NPPES record last updated: December 29, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 29, 2025, Dec 18, 2025, Oct 13, 2023 and 1 more (4 updates tracked since 2023).

About Dr. William C Pederson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WILLIAM C PEDERSON M.D. (NPI 1053387902) is an individual plastic and reconstructive surgery provider in Houston, Texas, licensed in Texas (F1893) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Houston, and is a graduate of University Of Texas Southwestern Medical School At Dallas (1978).

NPPES Registry Identity

NPI1053387902
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameDR. WILLIAM C PEDERSONCredential: M.D.
Location Address1977 BUTLER BLVD STE E6100Houston, TX 77030-4101
Mailing Address6701 Fannin St Ste 610.00Houston, TX 77030-2608 · (832) 822-3180
Sole ProprietorNo
Medical School CMSUniversity Of Texas Southwestern Medical School At DallasGraduated 1978
Enumeration DateFebruary 28, 2006
Last NPPES UpdateDecember 29, 20254 updates tracked since enumeration
NPPES CertifiedDecember 29, 2025
NPI 1053387902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License Licensed in TX · F1893
Definition

A surgeon who specializes in plastic and reconstructive surgery.

Also ListedPlastic SurgeryTaxonomy 208200000X · License F1893 (TX)
Also ListedPlastic Surgery · Surgery of the HandTaxonomy 2082S0105X · License F1893 (TX)
Also ListedSurgery · Surgery of the HandTaxonomy 2086S0105X · License F1893 (TX)
1977 BUTLER BLVD STE E6100, Houston, TX 77030

Secondary Practice Location 1

Location 16701 Fannin St Ste 610.00Houston, TX 77030-2608 · Phone (832) 822-3180

Other Identifiers 1

Medicaid133003703TX

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. William C Pederson M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597860890
PECOS Enrollment IDI20100415000254
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Surgery
1977 BUTLER BLVD STE E6100
HOUSTON, TX 77030

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053387902, enumerated as an "individual" on February 28, 2006.

The provider is located at 1977 BUTLER BLVD STE E6100 HOUSTON, TX 77030 and the phone number is (713) 798-6141.

Surgery with taxonomy code 2086S0122X and a focus in Plastic and Reconstructive Surgery.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Community. Please consult your insurance carrier or call the provider to verify.