MEDICARE: DR. BARNEY DRAKE WILLIAMS

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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1508098575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARNEY DRAKE WILLIAMS

Provider Business Mailing Address
First Line	:	1615 RUTLAND ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-4037
Country	:	US
Telephone Number	:	713-426-8300
Fax Number	:	713-426-8310

Provider Business Practice Location Address
First Line	:	1615 RUTLAND ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-4037
Country	:	US
Telephone Number	:	713-426-8300
Fax Number	:	713-426-8310

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

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	08/10/2009

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