Provider Demographics
NPI:1952578536
Name:WILLIAMS, STEPHEN BENTLEY (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:BENTLEY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:JOHN SEALY ANNEX, RM. 6.310
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0540
Mailing Address - Country:US
Mailing Address - Phone:409-772-2091
Mailing Address - Fax:409-772-5144
Practice Address - Street 1:2240 GULF FREEWAY
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:832-505-1800
Practice Address - Fax:281-309-0419
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9767208800000X
CAA116665208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX337459701Medicaid
TX337459701Medicaid