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NPI Code Detail

MEDICARE: E P TED WILLIAMS MDPA

MEDICARE: E P TED WILLIAMS MDPA
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
12084P0804XChild & Adolescent Psychiatry PhysicianG3912TX
2261QM1300XMulti-Specialty Clinic/Center
32084P0800XPsychiatry PhysicianG3912TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518190859
Entity Type Code : Organization
Provider Name (Legal Business Name) : E P TED WILLIAMS MDPA
Provider Business Mailing Address
First Line : 7122 STONEWALL HL
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78256-1926
Country : US
Telephone Number : 210-404-9696
Fax Number : 210-404-9466
Provider Business Practice Location Address
First Line : 7122 STONEWALL HL
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78256-1926
Country : US
Telephone Number : 210-404-9696
Fax Number : 210-404-9466
Authorized Official
Title or Position : OWNER
Name : DR. EDMUND PAYNE WILLIAMS IV
Credential : M.D.
Telephone Number : 210-404-9696
Provider Enumeration Date : 09/03/2009
Last Update Date : 05/14/2025

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