Provider Demographics
NPI:1679649032
Name:WILLIAMS KEATON, TONI (MD)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:WILLIAMS KEATON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:ELIECE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7500 RIALTO BLVD STE 1-140
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8534
Mailing Address - Country:US
Mailing Address - Phone:512-730-3056
Mailing Address - Fax:888-730-1925
Practice Address - Street 1:1401 ST JOSEPH PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8301
Practice Address - Country:US
Practice Address - Phone:512-730-3056
Practice Address - Fax:888-730-1925
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6040207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00471669OtherRR MEDICARE
TX045466203Medicaid
TX045466201Medicaid
TX1679649032OtherSCOTT & WHITE HEALTH PLAN
TX8AN224OtherBCBS TX
TX045466203Medicaid
TX8K9363Medicare PIN
G49254Medicare UPIN
TXP00471669OtherRR MEDICARE
TXTXB125615Medicare PIN