MEDICARE: BEVERLY ANN WILLIAMS

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
1	103T00000X	Psychologist	40012	TX

General Provider Information

NPI Number	:	1720946700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY ANN WILLIAMS

Provider Business Mailing Address
First Line	:	1517 WILLIAM WALLACE ST
Second Line	:
City	:	CRANDALL
State	:	TX
Zip	:	75114-5229
Country	:	US
Telephone Number	:	401-649-0789
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 TRAVIS ST STE 102
Second Line	:
City	:	ROANOKE
State	:	TX
Zip	:	76262-8605
Country	:	US
Telephone Number	:	817-437-4505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	03/24/2026

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Directions to “ BEVERLY ANN WILLIAMS ” Practice Location

Language	Start Address	Practice Location

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