Provider Demographics
NPI:1932137379
Name:WILLIAMS, TEARANI J (MD)
Entity Type:Individual
Prefix:
First Name:TEARANI
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 SIERRA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2480
Mailing Address - Country:US
Mailing Address - Phone:972-443-5300
Mailing Address - Fax:972-432-0498
Practice Address - Street 1:6500 SIERRA DR STE 150
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2480
Practice Address - Country:US
Practice Address - Phone:972-443-5300
Practice Address - Fax:972-432-0498
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2015207Q00000X
TXN3388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203688103Medicaid
TX209810103Medicaid
TX203688101Medicaid
AR135546001Medicaid
TX8L16961Medicare PIN
AR5L001Medicare PIN
TX209810103Medicaid
TX203688103Medicaid
TX8L16872Medicare PIN