Provider Demographics
NPI:1134560212
Name:WILLIAMS, NEVAN CLAY (RRT)
Entity type:Individual
Prefix:
First Name:NEVAN
Middle Name:CLAY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25622 TRANQUIL RIM
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-2483
Mailing Address - Country:US
Mailing Address - Phone:210-373-0740
Mailing Address - Fax:
Practice Address - Street 1:25622 TRANQUIL RIM
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-2483
Practice Address - Country:US
Practice Address - Phone:210-373-0740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55560227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered