Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | H9732 | TX |
N | 207PE0004X | Emergency Medical Services | H9732 | TX |
NPI | 1033180252 |
---|---|
Provider Name | Dr. Vernon Florinzel Williams |
First Address | Shavano Park, TX 78231-1458 |
Second Address | Jourdanton, TX 78026-1504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 29/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
139715017 | (05) | TX |
139715022 | (05) | TX |
E75371 | (02) | TX |