Provider Demographics
NPI:1205086253
Name:WILLIAMS, MARION OPHELIA (MD)
Entity type:Individual
Prefix:MS
First Name:MARION
Middle Name:OPHELIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10807 PERN BETL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-3144
Mailing Address - Country:US
Mailing Address - Phone:210-245-7892
Mailing Address - Fax:210-245-7951
Practice Address - Street 1:10807 PERN BETL RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-3144
Practice Address - Country:US
Practice Address - Phone:210-245-7862
Practice Address - Fax:210-245-7951
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ94422084P0800X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134730408Medicaid
TXP089204J2Medicaid
TX892047Medicare PIN
TXG02808Medicare UPIN