MEDICARE: DAVID ALLAN WILLIAMSON M.B., CH.B.

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	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician	R0977	TX
2	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician	D43756	MD
3	2084P0301X	Brain Injury Medicine (Psychiatry & Neurology) Physician	D43756	TX
4	2084P0301X	Brain Injury Medicine (Psychiatry & Neurology) Physician	R0977	TX

General Provider Information

NPI Number	:	1215183512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ALLAN WILLIAMSON M.B., CH.B.

Provider Business Mailing Address
First Line	:	25511 HAVEN LAKE DR
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375-2630
Country	:	US
Telephone Number	:	410-463-0560
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 RIVERWAY STE 600
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-1993
Country	:	US
Telephone Number	:	713-589-4122
Fax Number	:

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

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	07/21/2022

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