MEDICARE: DUSTIN WILLIAMS NP

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	363L00000X	Nurse Practitioner	1073713	TX
2	363LF0000X	Family Nurse Practitioner	1073713	TX

General Provider Information

NPI Number	:	1700411667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUSTIN WILLIAMS NP

Provider Business Mailing Address
First Line	:	1402 S CUSTER RD STE 704
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-1453
Country	:	US
Telephone Number	:	469-915-5069
Fax Number	:	469-915-4118

Provider Business Practice Location Address
First Line	:	1402 S CUSTER RD STE 704
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-1453
Country	:	US
Telephone Number	:	469-915-5069
Fax Number	:	469-915-4118

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

Provider Enumeration Date	:	03/11/2020
Last Update Date	:	04/04/2025

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Directions to “ DUSTIN WILLIAMS NP” Practice Location

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