Provider Demographics
NPI:1912028622
Name:WILLIAMS, BRIAN PAUL (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:PAUL
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3621 22ND ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1301
Mailing Address - Country:US
Mailing Address - Phone:806-791-8484
Mailing Address - Fax:806-791-8499
Practice Address - Street 1:3621 22ND ST
Practice Address - Street 2:SUITE 400
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1301
Practice Address - Country:US
Practice Address - Phone:806-791-8484
Practice Address - Fax:806-791-8499
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP1607207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB155180OtherMEDICARE PTAN