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General NPI Number Information
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NPI Number | 1588016554
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Entity Type | Individual
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Provider Name | DEREK WILLIAMS DDS
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Gender | Male
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Dates
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Enumeration Date | 07/01/2016
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Last Update Date | 07/01/2016
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Provider Practice Location Address
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Address Line | 701 S JOHN REDDITT DR
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City | LUFKIN
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State | TX
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Zip | 75904-3122
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Country | US
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Telephone | 936-634-5012
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 HANKS ST
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City | LUFKIN
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State | TX
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Zip | 75904-5477
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Country | US
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Telephone | 801-310-3658
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 9831192-9921
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 31939
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License Number State | TX
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