Provider Demographics
NPI:1457561664
Name:WILLIAMS, WALTER HOWARD (DPM)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:HOWARD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 VISCOUNT BLVD APT 147
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-5718
Mailing Address - Country:US
Mailing Address - Phone:915-549-5461
Mailing Address - Fax:
Practice Address - Street 1:1605 GEORGE DIETER DR STE 636
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-5692
Practice Address - Country:US
Practice Address - Phone:915-274-1617
Practice Address - Fax:915-219-9022
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1725213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine