Provider Demographics
NPI:1245288737
Name:WILLIAMS, TERRY D (DC)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-5243
Mailing Address - Country:US
Mailing Address - Phone:903-874-5866
Mailing Address - Fax:903-874-5083
Practice Address - Street 1:219 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-5243
Practice Address - Country:US
Practice Address - Phone:903-874-5866
Practice Address - Fax:903-874-5083
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9221111N00000X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
00Y226OtherMEDICARE GROUP
TXV08442Medicare UPIN
TX8L4482Medicare PIN