MEDICARE: DR. BENJAMIN AUDE MCWILLIAMS M. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	E2723	TX

General Provider Information

NPI Number	:	1033165105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN AUDE MCWILLIAMS M. D.

Provider Business Mailing Address
First Line	:	6659 GASCONY PL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3575
Country	:	US
Telephone Number	:	817-423-9653
Fax Number	:

Provider Business Practice Location Address
First Line	:	6659 GASCONY PL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3575
Country	:	US
Telephone Number	:	817-423-9653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	12/31/2008

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