Individual
GRANT DAVID WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 WONDER WORLD DR, SAN MARCOS, TX 78666-7533
(512) 753-3796
Mailing address
2314 RIDGECREST ST, SAN MARCOS, TX 78666-4923
(512) 667-6817
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M4656
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8V3081
BCBS
TX
Enumeration date
06/13/2006
Last updated
03/25/2008
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