Healthcare Provider Details

I. General information

NPI: 1881971091
Provider Name (Legal Business Name): RICHARD W. WILLIAMSON, M.D. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W MAIN SUITE 200
LEWISVILLE TX
75057-2783
US

IV. Provider business mailing address

5000 LONG PRAIRIE RD
FLOWER MOUND TX
75028-2783
US

V. Phone/Fax

Practice location:
  • Phone: 972-420-1776
  • Fax: 972-436-6996
Mailing address:
  • Phone: 972-420-1776
  • Fax: 972-436-6996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD6211
License Number StateTX

VIII. Authorized Official

Name: LINDA JANICE HINKLE
Title or Position: MANAGED CARE COORDINATOR
Credential:
Phone: 214-222-6615