Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | J1815 | TX |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | J1815 | TX |
Y | 207XS0117X | Orthopaedic Spine Surgeon | J1815 | TX |
NPI | 1720052079 |
---|---|
Provider Name | John J Williams |
First Address | Austin, TX 78723 |
Second Address | Austin, TX 78723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 18/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1624223-02 | (05) | TX |
162422303 | MEDICAID CSHCN (01) | TX |
1624223-06 | (05) | TX |
1624223-07 | MEDICAID CSHCN ROT (01) | TX |
87W190 | BCBS INDIVIDUAL # (01) | TX |