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NPI Code Detail

MEDICARE: NATHANIEL JOHNATHAN WILLIAMS RBT

MEDICARE: NATHANIEL JOHNATHAN WILLIAMS RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1417694589
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHANIEL JOHNATHAN WILLIAMS RBT
Provider Business Mailing Address
First Line : 7500 SAN FELIPE ST STE 990
Second Line :
City : HOUSTON
State : TX
Zip : 77063-1708
Country : US
Telephone Number : 832-742-0001
Fax Number :
Provider Business Practice Location Address
First Line : 4541 N BENTWOOD DR
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-8229
Country : US
Telephone Number : 325-939-2650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2022
Last Update Date : 05/19/2022

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