Myndie Willis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6027 Issued in TX

Practice address

4916 Knickerbocker Rd
San Angelo, TX 76904-7517

Phone

(325) 949-1112

Fax

(325) 949-5551

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295843894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4916 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047517",
            "telephone_number": "325-949-1112",
            "fax_number": "325-949-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4916 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047517",
            "telephone_number": "325-949-1112",
            "fax_number": "325-949-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MYNDIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall L Williams, PT
• Stephanie Williams, FNP-C
• Torri D Williams, PHARM.D.
• Leslie K Williamson, MD
• Olivia Williamson, OT
• Cameron Marlane Wilson, DNP, MSN, APRN, FNP-
• Daniel M Wilson, MD
• Jerrye Lyn Wilson, SLP
• Kelly W Wilson, MD
• Kylan Wilson, CERTIFIED PEDORTHIST

• Chiropractor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.