Active NPI
Gary W Williamson, MD
- Emergency Medicine Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- F2120
- Practice address
- 800 E Dawson St
Tyler, TX 75701-2036 - Phone
- (903) 593-8441
- NPI assigned
- Jun 12, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | F2120 | TX | Primary |
Addresses
Primary practice location
800 E Dawson St
Tyler, TX 75701-2036
Mailing address
PO Box 841656
Dallas, TX 75284-1656
Phone (903) 531-5000
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 139811722 | Medicaid | TX | |
| 8CU714 | Other | TX | BCBS |
| 0042EJ | Other | TX | BCBS |
| 080126648 | Other | TX | RAIL ROAD |
| 75-0818167-022 | Other | TX | TRICARE |
| 75-0818167-048 | Other | TX | TRICARE |
| 8M5091 | Other | TX | BCBS |
| TIN PLUS 044 | Other | TX | TRICARE WINNSBORO LOCATION |
| 75-2616977 | Other | TX | RAIL ROAD |
| 75-2616977-028 | Other | TX | TRICARE |
| TIN PLUS 015 | Other | TX | TRICARE TYLER LOCATION |
| 139811714 | Medicaid | TX | |
| 75-2616977-001 | Other | TX | TRICARE |
| 139811724 | Medicaid | TX | |
| 75-2616977-002 | Other | TX | TRICARE |
| 139811723 | Medicaid | TX | |
| TIN PLUS 005 | Other | TX | TRICARE |
| 139811721 | Medicaid | TX |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mother Frances Hospital Jacksonville | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Mother Frances Hospital Regional Health Care Center | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Mother Frances Hospital Winnsboro | Past | Accepting new patients | |
| Mother Frances Hospital | Past | Accepting new patients |
Locations
2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500
3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000
700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018
719 W Coke Rd
Ste 4
Winnsboro, TX 75494
Phone (903) 342-3760
Interoperability endpoints
- gwilliamson7631@christushealth.direct-ci.net
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
-
- Critical Access Hospital
- Jacksonville, TX
- NPI 1952306672
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
- Certified Registered Nurse Anesthetist
- Tyler, TX
- NPI 1629185210
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1922294867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426464000000",
"number": "1851333850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 841656",
"city": "DALLAS",
"state": "TX",
"postal_code": "752841656",
"telephone_number": "903-531-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E DAWSON ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757012036",
"telephone_number": "903-593-8441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "GARY",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2015-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "F2120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139811722",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8CU714",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0042EJ",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD",
"identifier": "080126648",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-0818167-022",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-0818167-048",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8M5091",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE WINNSBORO LOCATION",
"identifier": "TIN PLUS 044",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD",
"identifier": "75-2616977",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-2616977-028",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE TYLER LOCATION",
"identifier": "TIN PLUS 015",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139811714",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-2616977-001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139811724",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "75-2616977-002",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139811723",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "TIN PLUS 005",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139811721",
"state": "TX"
}
],
"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 Mar 16, 2015; 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.