Healthcare Provider Details

I. General information

NPI: 1346997764
Provider Name (Legal Business Name): DR. JOAN M WILLIAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2022
Last Update Date: 09/29/2026
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2214 MICHIGAN AVE STE H
DWG TX
76013-5952
US

IV. Provider business mailing address

2214 MICHIGAN AVE STE H
DWG TX
76013-5952
US

V. Phone/Fax

Practice location:
  • Phone: 800-221-9001
  • Fax:
Mailing address:
  • Phone: 800-221-9001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number40810
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number40810
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number40810
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: