MEDICARE: DR. ANNETTE JUNE WILLIAMSON OD

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	152W00000X	Optometrist	4227	TX

General Provider Information

NPI Number	:	1235201781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNETTE JUNE WILLIAMSON OD

Provider Business Mailing Address
First Line	:	4400 FREDERICKSBURG RD
Second Line	:	STE 107
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-1969
Country	:	US
Telephone Number	:	210-737-1926
Fax Number	:	210-737-2621

Provider Business Practice Location Address
First Line	:	238 BROOKLEY AVENUE
Second Line	:
City	:	BOLLING AIR FORCE BASE
State	:	DC
Zip	:	20032-7050
Country	:	US
Telephone Number	:	202-767-1868
Fax Number	:

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/01/2016

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