Provider Demographics
NPI:1750845343
Name:WILLIAMS, JEREMIAH JEFF (NP)
Entity type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:JEFF
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5929 BALCONES DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4280
Mailing Address - Country:US
Mailing Address - Phone:512-550-1800
Mailing Address - Fax:877-647-0202
Practice Address - Street 1:5826 ESPLANADE DR STE 304A
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4173
Practice Address - Country:US
Practice Address - Phone:361-221-5227
Practice Address - Fax:877-647-0202
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily