Provider Demographics
NPI:1235672429
Name:WILLIAMS, EUGIE ERIC III (PT, DPT)
Entity Type:Individual
Prefix:
First Name:EUGIE
Middle Name:ERIC
Last Name:WILLIAMS
Suffix:III
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 TURTLE CREEK BLVD
Mailing Address - Street 2:STE 615
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5405
Mailing Address - Country:US
Mailing Address - Phone:214-528-3378
Mailing Address - Fax:214-528-3379
Practice Address - Street 1:3131 TURTLE CREEK BLVD
Practice Address - Street 2:STE 615
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5405
Practice Address - Country:US
Practice Address - Phone:214-528-3378
Practice Address - Fax:214-528-3379
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1283906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z973Medicare PIN