MEDICARE: MR. JAMES FRANK WILLIAMS PAC

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	363AS0400X	Surgical Physician Assistant	PAO1988	TX

General Provider Information

NPI Number	:	1548232689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES FRANK WILLIAMS PAC

Provider Business Mailing Address
First Line	:	15410 BLUFFVIEW ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-4022
Country	:	US
Telephone Number	:	210-491-4233
Fax Number	:

Provider Business Practice Location Address
First Line	:	3851 ROGER BROOKE DR
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4501
Country	:	US
Telephone Number	:	210-916-4153
Fax Number	:	210-916-2211

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	07/08/2007

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