Provider Demographics
NPI:1891861803
Name:WILLIAMS, SCOTT TIMOTHY (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:TIMOTHY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1405 E TYLER STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-2724
Mailing Address - Country:US
Mailing Address - Phone:903-677-0255
Mailing Address - Fax:903-677-0229
Practice Address - Street 1:1405 E TYLER STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-2724
Practice Address - Country:US
Practice Address - Phone:903-677-0255
Practice Address - Fax:903-677-0229
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5042T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist