Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP1-0031982 | TX |
N | 111NI0900X | Internist | BP1-0031982 | TX |
Y | 207RC0000X | Internist - Cardiovascular Disease | P6111 | TX |
NPI | 1023251410 |
---|---|
Provider Name | Dr. Brandie Deann Williams |
First Address | Granbury, TX 76049-1219 |
Second Address | Fort Worth, TX 76104-2810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2009 |
Last Update Date | 01/08/2014 |