Active NPI
David Stuart Williams
- Student in an Organized Health Care Education/Training Program
- Tyler, TX
National Provider Identifier
1316252984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1401 Woodland Hills Dr
Tyler, TX 75701-8527 - Phone
- (903) 521-2221
- NPI assigned
- Aug 8, 2010
- Last updated
- Aug 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Paramedic | 146L00000X | 12218 | TX | |
| Emergency Registered Nurse | 163WE0003X | 694863 | TX | |
| Pharmacy Technician | 183700000X | 5001-0701-0049-881 | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1401 Woodland Hills Dr
Tyler, TX 75701-8527
Mailing address
PO Box 9693
Tyler, TX 75711-2693
Phone (903) 521-2221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12218 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| 694863 | TX | MD | Emergency Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281225600000",
"number": "1316252984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9693",
"city": "TYLER",
"state": "TX",
"postal_code": "757112693",
"telephone_number": "903-521-2221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 WOODLAND HILLS DR",
"city": "TYLER",
"state": "TX",
"postal_code": "757018527",
"telephone_number": "903-521-2221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DAVID",
"middle_name": "STUART",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-08",
"last_updated": "2010-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "146L00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Paramedic",
"state": "TX",
"license": "12218",
"primary": false
},
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "TX",
"license": "694863",
"primary": false
},
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": null,
"license": "5001-0701-0049-881",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.