Individual provider Active NPI

Justin Barrett Williams, M.D.

  • Emergency Medicine Physician
  • Fort Sam Houston, TX
National Provider Identifier
1578511846
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35085855 Issued in OH
Practice address
3851 Roger Brooke Dr
Fort Sam Houston, TX 78234-4501
Phone
(210) 916-0808
Fax
(210) 916-2265
NPI assigned
May 5, 2006
Last updated
Nov 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35085855 OH Primary

Addresses

Primary practice location

3851 Roger Brooke Dr
Fort Sam Houston, TX 78234-4501

Mailing address

3511 Hilldale PT
San Antonio, TX 78261-2353
Phone (210) 507-7069

Other identifiers 1

IdentifierTypeStateIssuer
2570472MedicaidOH

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
I20071130000554 TX Practitioner - Emergency Medicine 5092750133 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35085855OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

134 Menger Spgs
Boerne, TX 78006
Phone (830) 331-3000

12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

6402 Mallard Mdw
San Antonio, TX 78244
Phone (210) 757-5000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1578511846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 HILLDALE PT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782612353",
            "telephone_number": "210-507-7069",
            "fax_number": "210-507-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344501",
            "telephone_number": "210-916-0808",
            "fax_number": "210-916-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JUSTIN",
        "middle_name": "BARRETT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35085855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2570472",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.