Provider Demographics
NPI:1689746935
Name:MCWILLIAMS, BENNIE C (MD)
Entity Type:Individual
Prefix:DR
First Name:BENNIE
Middle Name:C
Last Name:MCWILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 NORTHLAND DR
Mailing Address - Street 2:SUITE 512
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4961
Mailing Address - Country:US
Mailing Address - Phone:512-380-9200
Mailing Address - Fax:512-380-9201
Practice Address - Street 1:3305 NORTHLAND DR
Practice Address - Street 2:SUITE 512
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4961
Practice Address - Country:US
Practice Address - Phone:512-380-9200
Practice Address - Fax:512-380-9201
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF18122080P0214X
NM81-902080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX106192103Medicaid
TXC19243Medicare UPIN