Provider Demographics
NPI:1548797715
Name:WILLIAMS, DEVIN (OD)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EXECUTIVE CENTER BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1004
Mailing Address - Country:US
Mailing Address - Phone:915-532-3937
Mailing Address - Fax:
Practice Address - Street 1:400 EXECUTIVE CENTER BLVD STE 600
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1004
Practice Address - Country:US
Practice Address - Phone:915-532-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002578152W00000X
TX10475152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist