Healthcare Provider Details

I. General information

NPI: 1356316814
Provider Name (Legal Business Name): CAROLINE B WILLIAMS PHD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 ESCALERA CIR
BOERNE TX
78006-2963
US

IV. Provider business mailing address

112 ESCALERA CIR
BOERNE TX
78006-2963
US

V. Phone/Fax

Practice location:
  • Phone: 830-347-4027
  • Fax: 505-570-4560
Mailing address:
  • Phone: 830-347-4027
  • Fax: 800-866-8791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number911
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number20
License Number StateNM

VIII. Authorized Official

Name: DR. CAROLINE B WILLIAMS
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 505-819-0859