Provider Demographics
NPI:1205869302
Name:JACQUET-WILLIAMS, ROBIN (MD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:JACQUET-WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 SAN PEDRO AVE STE 412
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4361
Mailing Address - Country:US
Mailing Address - Phone:210-281-8669
Mailing Address - Fax:210-314-5044
Practice Address - Street 1:17323 IH 35 N
Practice Address - Street 2:STE 113
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1277
Practice Address - Country:US
Practice Address - Phone:210-543-7334
Practice Address - Fax:210-314-5044
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5141207P00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138565009Medicaid
TX88683FOtherBCBS
TXE03456Medicare UPIN
TX88683FOtherBCBS
TX88683FMedicare PIN