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:
Health care specialties
Specialty | Code | License # | 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 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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