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General NPI Number Information
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NPI Number | 1851883151
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Entity Type | Individual
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Provider Name | BRYAN P WILLIAMS OD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 1512 8TH AVE STE 100
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City | FORT WORTH
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State | TX
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Zip | 76104-4150
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Country | US
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Telephone | 817-759-9200
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Fax | 817-759-9201
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Provider Business Mailing Address
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Address Line | 1512 8TH AVE STE 100
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City | FORT WORTH
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State | TX
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Zip | 76104-4150
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Country | US
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Telephone | 817-759-9200
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Fax | 177-599-2018
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9481
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License Number State | TX
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