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NPI Code Detail

MEDICARE: WILLIAMS FAMILY PRACTICE, P A

MEDICARE: WILLIAMS FAMILY PRACTICE, P A
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
1207Q00000XFamily Medicine PhysicianL2751TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10041GWOTHERTXBCBS GROUP
21932103629OTHERTXNPI
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
58B9860OTHERTXBCBS PROVIDER

General Provider Information

NPI Number : 1881898922
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILLIAMS FAMILY PRACTICE, P A
Provider Business Mailing Address
First Line : 309 E CROCKETT ST STE A
Second Line :
City : CLEVELAND
State : TX
Zip : 77327-3810
Country : US
Telephone Number : 281-592-2656
Fax Number : 281-592-9723
Provider Business Practice Location Address
First Line : 309 E CROCKETT ST
Second Line : SUITE A
City : CLEVELAND
State : TX
Zip : 77327-3810
Country : US
Telephone Number : 281-592-2656
Fax Number : 281-592-9723
Authorized Official
Title or Position : M.D.
Name : BALMORE WILLOUGHBY WILLIAMS
Credential : MD
Telephone Number : 281-592-2656
Provider Enumeration Date : 06/13/2007
Last Update Date : 03/12/2014

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Directions to “WILLIAMS FAMILY PRACTICE, P A ” Practice Location

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