Provider Demographics
NPI:1356520423
Name:WILLIAMS, BOBBIE SUE THOMPSON (DC)
Entity type:Individual
Prefix:DR
First Name:BOBBIE
Middle Name:SUE THOMPSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:BOBBIE
Other - Middle Name:SUE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3304 SE LOOP 820 STE B
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-1113
Mailing Address - Country:US
Mailing Address - Phone:817-615-8633
Mailing Address - Fax:682-301-3066
Practice Address - Street 1:3304 SE LOOP 820 STE B
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76140-1113
Practice Address - Country:US
Practice Address - Phone:817-615-8633
Practice Address - Fax:682-301-3066
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC10397111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor