Provider Demographics
NPI:1003219767
Name:WILLIAMS, ERIC LEE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:LEE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4206 CALL FIELD RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-2519
Mailing Address - Country:US
Mailing Address - Phone:940-397-5200
Mailing Address - Fax:940-397-5292
Practice Address - Street 1:4206 CALL FIELD RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-2519
Practice Address - Country:US
Practice Address - Phone:940-397-5200
Practice Address - Fax:940-397-5292
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX706477363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner