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General NPI Number Information
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NPI Number | 1215961263
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Entity Type | Organization
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Legal Business Name | SPECTRUM ANESTHESIA & PAIN SERVICES, P.A.
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 5017 S MCCOLL RD STE D
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City | EDINBURG
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State | TX
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Zip | 78539-7884
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Country | US
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Telephone | 956-630-6301
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Fax | 956-630-6019
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Provider Business Mailing Address
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Address Line | PO BOX 720658
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City | MCALLEN
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State | TX
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Zip | 78504-0658
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Country | US
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Telephone | 956-630-6301
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Fax | 956-630-6019
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH E. WILLIAMS
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Credential | M.D.
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Telephone | 956-630-6301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G17185
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License Number State | TX
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