Provider Demographics
NPI:1942257209
Name:WILLIAMS, DELWIN (MD)
Entity Type:Individual
Prefix:
First Name:DELWIN
Middle Name:
Last Name:WILLIAMS
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:PO BOX 99335
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0335
Mailing Address - Country:US
Mailing Address - Phone:817-927-3638
Mailing Address - Fax:817-923-8769
Practice Address - Street 1:855 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2553
Practice Address - Country:US
Practice Address - Phone:817-927-3638
Practice Address - Fax:817-923-8769
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH29032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132233107Medicaid
TXP00275248OtherRAILROAD MEDICARE
TX8U1305OtherBCBS
TXP00275248OtherRAILROAD MEDICARE
TXC23557Medicare UPIN