Provider Demographics
NPI:1629233143
Name:WILLIAMS, EDWARD LANOY (PA)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:LANOY
Last Name:WILLIAMS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:11212 STATE HIGHWAY 151
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4498
Mailing Address - Country:US
Mailing Address - Phone:210-681-5747
Mailing Address - Fax:210-681-7515
Practice Address - Street 1:11212 STATE HIGHWAY 151
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4498
Practice Address - Country:US
Practice Address - Phone:210-681-5747
Practice Address - Fax:210-681-7515
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2014-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA04755363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical