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General NPI Number Information
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NPI Number | 1518190859
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Entity Type | Organization
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Legal Business Name | E P TED WILLIAMS MDPA
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 7122 STONEWALL HL
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City | SAN ANTONIO
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State | TX
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Zip | 78256-1926
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Country | US
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Telephone | 210-404-9696
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Fax | 210-404-9466
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Provider Business Mailing Address
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Address Line | 7122 STONEWALL HL
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City | SAN ANTONIO
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State | TX
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Zip | 78256-1926
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Country | US
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Telephone | 210-404-9696
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Fax | 210-404-9466
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDMUND PAYNE WILLIAMS IV
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Credential | M.D.
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Telephone | 210-404-9696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | G3912
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G3912
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License Number State | TX
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