NPIMap

Organization Active NPI

E P Ted Williams Mdpa

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1518190859
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G3912 Issued in TX
Legal business name
E P TED WILLIAMS MDPA
Practice address
7122 Stonewall HL
San Antonio, TX 78256-1926
Phone
(210) 404-9696
Fax
(210) 404-9466
NPI assigned
Sep 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Authorized official

Name
Dr. Edmund Payne Williams IV, M.D.NPI 1457345423
Title
Owner
Phone
(210) 404-9696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X G3912 TX Primary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0804X G3912 TX
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

7122 Stonewall HL
San Antonio, TX 78256-1926

Mailing address

7122 Stonewall HL
San Antonio, TX 78256-1926
Phone (210) 404-9696

Other identifiers 1

IdentifierTypeStateIssuer
138419010MedicaidTX

Other names 1

  • Genesis Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250110000263 TX Part B Supplier - Clinic/Group Practice 2567990179 Receives reassigned benefits from 10 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

7122 Stonewall Hl
San Antonio, TX 78256
Phone (210) 404-9696

1380 Pantheon Way
Ste 310
San Antonio, TX 78232
Phone (210) 404-9696

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1518190859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7122 STONEWALL HL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782561926",
            "telephone_number": "210-404-9696",
            "fax_number": "210-404-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7122 STONEWALL HL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782561926",
            "telephone_number": "210-404-9696",
            "fax_number": "210-404-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E P TED WILLIAMS MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-03",
        "last_updated": "2025-05-14",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "PAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-404-9696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "G3912",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "G3912",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138419010",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.