Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 12-00370 | KS |
Y | 222Z00000X | Podiatrist | 12-00370 | KS |
N | 213ES0103X | Foot & Ankle Surgery | 1850 | TX |
NPI | 1053593483 |
---|---|
Provider Name | Chester Williams III |
First Address | Wichita Falls, TX 76302-2302 |
Second Address | Wichita Falls, TX 76302-2302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2007 |
Last Update Date | 26/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14094005 | (02) | KS |
200589790A | (05) | KS |
KA1610002 | (02) | KS |