Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 81-90 | NM |
N | 2080P0214X | Pediatric Pulmonologist | F1812 | TX |
NPI | 1689746935 |
---|---|
Provider Name | Dr. Bennie C Mcwilliams |
First Address | Austin, TX 78731-4961 |
Second Address | Austin, TX 78731-4961 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 20/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
106192103 | (05) | TX |
C19243 | (02) | TX |