Organization
WILLIAM T TIMMONS
Active
Other names
THE JASPER WOMEN'S CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENDA G WAGUSPACK (OFFICE MANAGER)
(409) 384-6000
Entity
Organization
Contact information
Practice address
2014 S WHEELER ST, SUITE 130, JASPER, TX 75951-5624
(409) 384-6000
(409) 384-2026
Mailing address
2014 S WHEELER ST, SUITE 130, JASPER, TX 75951-5624
(409) 384-6000
(409) 384-2026
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
E4720
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00AJ43
BLUE CROSS/SLUE SHIELD
TX
01
—
10110570
DPS
TX
01
—
E4720
STATE LICENSE
TX
Enumeration date
08/07/2007
Last updated
03/07/2023
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