Physician Compare National (NPI:1316974124)

HEALTHCARE PROVIDER: TONI WILLIS MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1316974124
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789766320
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081006000050
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILLIS
	Individual professional last name
Provider First Name	TONI
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	HOWARD UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2304 STATE HWY 121
	Group Practice or individual's line 1 address
City	BEDFORD
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	760215985
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8176842010
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y