Provider Demographics
NPI:1427050137
Name:WILLIAMS, FRED ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:ANDREW
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 FM 195
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-2821
Mailing Address - Country:US
Mailing Address - Phone:903-784-3200
Mailing Address - Fax:903-784-7405
Practice Address - Street 1:1900 FM 195
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-2821
Practice Address - Country:US
Practice Address - Phone:903-784-3200
Practice Address - Fax:903-784-7405
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2904207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134921903Medicaid
TX134921903Medicaid
TXTXB101844Medicare PIN