BWBL Group

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BWBL GROUP

Practice address

6770 Old Jacksonville Hwy Ste 101
Tyler, TX 75703-0576

Phone

(903) 352-3250

Fax

(903) 221-9183

NPI assigned

Nov 27, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Randall Blake Williams, NPNPI 1194365585

Title

Managing Partner

Phone

(903) 539-0768

Specialties & licenses 1

Addresses

Other names 1

• The Men's Clinic Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randall Blake Williams

  • Family Nurse Practitioner
  • Longview, TX
  • NPI 1194365585
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1093581597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6770 OLD JACKSONVILLE HWY STE 101",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030576",
            "telephone_number": "903-352-3250",
            "fax_number": "903-221-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6770 OLD JACKSONVILLE HWY STE 101",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030576",
            "telephone_number": "903-352-3250",
            "fax_number": "903-221-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BWBL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "903-539-0768",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Men's Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Latoya Butler
• Nicole Butler
• Angela Hope Buttram, BSN,MSN,FNP-C
• Jonathan William Buttram, MD
• Thomas M Buzbee Jr., M.D.
• Matthew Bynum, DC
• Payson Adrianna Bynum, DC
• Dan E Byrd, DDS
• Marcus A. Byrd, M.D.
• Todd Otto Byrne, OTR, CHT

• Primary Care Clinic/Center in Tyler, TX
• Providers in Tyler, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.