Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 10235 | TX |
N | 111NI0013X | Independent Medical Examiner | 10235 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 10235 | TX |
N | 111NX0100X | Occupational Health | 10235 | TX |
NPI | 1346397080 |
---|---|
Provider Name | Dr. Dennis Wayne Williamson |
First Address | Garland, TX 75043-4912 |
Second Address | Garland, TX 75043-4912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 14/12/2021 |