Organization
CENTRAL TEXAS PEDIATRIC ORTHOPEDICS AND SCOLIOSIS SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN WILLIAMS MD (PRESIDENT)
(512) 478-8116
Entity
Organization
Contact information
Practice address
12201 RENFERT WAY, SUITE 115, AUSTIN, TX 78758-5354
(512) 478-8116
(512) 478-9368
Mailing address
12201 RENFERT WAY, SUITE 115, AUSTIN, TX 78758-5354
(512) 478-8116
(512) 478-9368
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
TX
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N43X
BCBS GROUP #
TX
05
—
1624215-03
—
TX
01
—
162421504
MEDICAID CSHCN
TX
Enumeration date
02/14/2007
Last updated
08/08/2008
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