MEDICARE: DR. BOBBIE SUE THOMPSON WILLIAMS D.C.

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	111N00000X	Chiropractor	DC10397	TX

General Provider Information

NPI Number	:	1356520423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BOBBIE SUE THOMPSON WILLIAMS D.C.

Provider Business Mailing Address
First Line	:	3304 SE LOOP 820 STE B
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76140-1113
Country	:	US
Telephone Number	:	817-615-8633
Fax Number	:	682-301-3066

Provider Business Practice Location Address
First Line	:	3304 SE LOOP 820 STE B
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76140-1113
Country	:	US
Telephone Number	:	817-615-8633
Fax Number	:	682-301-3066

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

Provider Enumeration Date	:	10/25/2007
Last Update Date	:	10/13/2020

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