Provider Demographics
NPI:1265437933
Name:WILLIAMSON, WILLIAM P (DC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:WILLIAMSON
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 1:145 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-4505
Mailing Address - Country:US
Mailing Address - Phone:409-384-5763
Mailing Address - Fax:409-384-1590
Practice Address - Street 1:145 CURTIS ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4505
Practice Address - Country:US
Practice Address - Phone:409-384-5763
Practice Address - Fax:409-384-1590
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC2824111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088363901Medicaid
TXDC2824OtherCHIROPRACTIC
TX601076OtherBLUE CROSS BLUE SHIELD
TXDC2824OtherCHIROPRACTIC
TXT16660Medicare UPIN