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General NPI Number Information
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NPI Number | 1407017031
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Entity Type | Individual
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Provider Name | RICHARD LEE WILLIAMS PA
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Gender | Male
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 1315 BROOKSIDE DR
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City | HURST
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State | TX
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Zip | 76053-3942
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Country | US
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Telephone | 817-268-7982
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Fax | 888-331-3527
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Provider Business Mailing Address
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Address Line | 1315 BROOKSIDE DR
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City | HURST
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State | TX
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Zip | 76053-3942
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Country | US
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Telephone | 817-268-7982
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Fax | 888-331-3527
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA05825
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License Number State | TX
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