Healthcare Provider Details

I. General information

NPI: 1134615917
Provider Name (Legal Business Name): ALEXANDER THOMAS WILLIAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N HIGHLAND AVE
SHERMAN TX
75092-7354
US

IV. Provider business mailing address

7500 RIALTO BLVD STE 1-140
AUSTIN TX
78735-8534
US

V. Phone/Fax

Practice location:
  • Phone: 903-870-4611
  • Fax:
Mailing address:
  • Phone: 512-730-3060
  • Fax: 888-730-1925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN27307
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberS9626
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: