Active NPI
Sean Williamson
- Pediatrics Physician
- Temple, TX
National Provider Identifier
1649965492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 764463
- Practice address
- 2401 S 31St St # Msag407Q
Temple, TX 76508-0001 - Phone
- (254) 724-5437
- NPI assigned
- Apr 7, 2023
- Last updated
- Jun 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 764463 | TX | Primary |
Addresses
Primary practice location
2401 S 31St St # Msag407Q
Temple, TX 76508-0001
Mailing address
4803 Bellfalls CT
Temple, TX 76502
Phone (205) 902-2581
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 764463 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1649965492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4803 BELLFALLS CT",
"city": "TEMPLE",
"state": "TX",
"postal_code": "76502",
"telephone_number": "205-902-2581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 S 31ST ST # MSAG407Q",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765080001",
"telephone_number": "254-724-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "SEAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-07",
"last_updated": "2023-06-29",
"certification_date": "2023-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "764463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.