MEDICARE: MR. RICHARD EMERSON WILLIAMS JR.

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	1041C0700X	Clinical Social Worker	119145	TX

General Provider Information

NPI Number	:	1427989888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD EMERSON WILLIAMS JR.

Provider Business Mailing Address
First Line	:	314 TAHOE AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-6564
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 GARDENDALE ST STE 104
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3143
Country	:	US
Telephone Number	:	210-612-4169
Fax Number	:

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

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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