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Individual
TED MICHAEL WILLIAMS
Active
Individual
TED MICHAEL WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04514
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184590101
—
TX
05
—
184590102
—
TX
01
—
75-2616977-042
TRICARE
TX
01
—
836N57
BCBS
TX
01
—
8N8739
BCBS OF TEXAS
TX
Enumeration date
08/18/2005
Last updated
02/25/2015
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