Healthcare Provider Details

I. General information

NPI: 1912028622
Provider Name (Legal Business Name): BRIAN PAUL WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 22ND ST SUITE 400
LUBBOCK TX
79410-1301
US

IV. Provider business mailing address

3621 22ND ST SUITE 400
LUBBOCK TX
79410-1301
US

V. Phone/Fax

Practice location:
  • Phone: 806-791-8484
  • Fax: 806-791-8499
Mailing address:
  • Phone: 806-791-8484
  • Fax: 806-791-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberP1607
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: