Provider Demographics
NPI:1083605273
Name:WILLIAMS, PETER J (DPM)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5825 CALLAGHAN RD
Mailing Address - Street 2:STE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1106
Mailing Address - Country:US
Mailing Address - Phone:210-227-8700
Mailing Address - Fax:210-348-9130
Practice Address - Street 1:1303 MCCULLOUGH AVE
Practice Address - Street 2:SUITE 348
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5609
Practice Address - Country:US
Practice Address - Phone:210-227-4164
Practice Address - Fax:210-227-6708
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0829213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092850903Medicaid
TX8A4608OtherBCBS
TX092850903Medicaid
TX8A4608OtherBCBS