Provider Demographics
NPI:1083929632
Name:JAMES A WILLIAMS, OD, PC
Entity Type:Organization
Organization Name:JAMES A WILLIAMS, OD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-516-0026
Mailing Address - Street 1:120 TOWN PL
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1822
Mailing Address - Country:US
Mailing Address - Phone:972-549-4255
Mailing Address - Fax:972-549-4257
Practice Address - Street 1:120 TOWN PL
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TX
Practice Address - Zip Code:75069-1822
Practice Address - Country:US
Practice Address - Phone:972-549-4255
Practice Address - Fax:972-549-4257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2011-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X719Medicare PIN