Individual provider Active NPI

Robert Clay Williams, D.O.

  • Urology Physician
  • Tyler, TX
National Provider Identifier
1144269697
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
M0970 Issued in TX
Practice address
700 Olympic Plaza Cir
Ste 700
Tyler, TX 75701-1951
Phone
(903) 262-3900
Fax
(903) 262-3993
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X M0970 TX Primary

Addresses

Primary practice location

700 Olympic Plaza Cir
Ste 700
Tyler, TX 75701-1951

Mailing address

700 Olympic Plaza Cir
Ste 700
Tyler, TX 75701-1951
Phone (903) 262-3900

Other identifiers 1

IdentifierTypeStateIssuer
173429501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000876 TX Practitioner - Urology 4486698255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

700 Olympic Plaza Cir
Suite 850
Tyler, TX 75701-1955
Phone (903) 596-3504

Hospital & facility affiliations

  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
  • University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
  • Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M0970TXMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Dec 1, 2019 Accepting new patients
Etmc Physician Group Inc. CurrentSince Sep 1, 2019 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Dec 1, 2019 Accepting new patients
Etmc Physician Group Inc. CurrentSince Sep 1, 2019 Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

910 E Houston St
Ste 470
Tyler, TX 75702
Phone (903) 526-2644

700 Olympic Plaza Cir
Ste 700
Tyler, TX 75701
Phone (903) 262-3900

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

911 S Beckham Ave
Tyler, TX 75701
Phone (903) 262-3900

Interoperability endpoints

  • Direct secure messaging: rwilliams330073@ahs.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1144269697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "STE 700",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-262-3900",
            "fax_number": "903-262-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "STE 700",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-262-3900",
            "fax_number": "903-262-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROBERT",
        "middle_name": "CLAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "M0970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173429501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.