Williams, Ted Michael

Williams, Ted Michael is an individual health care provider with primary practice located at 703 S Fleishel Ave Ste 4000 , Tyler TX 75701-2015. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Williams, Ted Michael can be contacted via phone (903) 606-7000.

Contact Information

Primary practice address
703 S Fleishel Ave Ste 4000 Tyler TX 75701-2015
Phone: (903) 606-7000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA04514 Texas

Profile Details

NPI number 1497747273
LBN Legal business name Williams, Ted Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Feb 25th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497747273 NPPES
Texas MEDICAID 184590102
Texas Other 75-2616977-042
Texas Other 836N57
Texas Other 8N8739
Texas MEDICAID 184590101

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