MEDICARE: DR. JUSTIN TERRELL WALLACE WILLIAMS PHARMD

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	183500000X	Pharmacist	76758	TX
2	1835P2201X	Ambulatory Care Pharmacist	23721	AL

General Provider Information

NPI Number	:	1477359099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN TERRELL WALLACE WILLIAMS PHARMD

Provider Business Mailing Address
First Line	:	4619 CALVERT RD NW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35816-1447
Country	:	US
Telephone Number	:	256-585-8869
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 S LANCASTER RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-7167
Country	:	US
Telephone Number	:	214-742-8387
Fax Number	:

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

Provider Enumeration Date	:	02/24/2025
Last Update Date	:	02/03/2026

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Directions to “ DR. JUSTIN TERRELL WALLACE WILLIAMS PHARMD” Practice Location

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