Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | M6956 | TX |
NPI | 1013929017 |
---|---|
Provider Name | Robert A. Williamson JR. |
First Address | Austin, TX 78759-5290 |
Second Address | Austin, TX 78731-3146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 21/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
187567611 | (05) | TX |
187567612 | (05) | TX |