Provider Demographics
NPI:1083106884
Name:WILLIAMS, ROBERT R
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6404 NURSERY DR STE 202
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1688
Mailing Address - Country:US
Mailing Address - Phone:361-333-5321
Mailing Address - Fax:361-576-0639
Practice Address - Street 1:6404 NURSERY DR STE 202
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1688
Practice Address - Country:US
Practice Address - Phone:361-333-5321
Practice Address - Fax:361-576-0639
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10064497207X00000X
TXU7540207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery