MEDICARE: ERIC BRANNON WILLIAMS MD

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	2084P0800X	Psychiatry Physician	P0809	TX
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1861622730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC BRANNON WILLIAMS MD

Provider Business Mailing Address
First Line	:	12801 N CENTRAL EXPY STE 350
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-1716
Country	:	US
Telephone Number	:	214-702-5336
Fax Number	:	972-773-9843

Provider Business Practice Location Address
First Line	:	12801 N CENTRAL EXPY STE 350
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-1716
Country	:	US
Telephone Number	:	214-702-5336
Fax Number	:	972-773-9843

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

Provider Enumeration Date	:	07/24/2009
Last Update Date	:	02/17/2022

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