Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0829 | TX |
NPI | 1083605273 |
---|---|
Provider Name | Peter J Williams |
First Address | San Antonio, TX 78228-1106 |
Second Address | San Antonio, TX 78212-5609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 10/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
092850903 | (05) | TX |
8A4608 | BCBS (01) | TX |
T16643 | (02) | TX |