Provider Demographics
NPI:1699162982
Name:WILLIAMS, RONALD DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DAVID
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:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:WHEELER
Mailing Address - State:TX
Mailing Address - Zip Code:79096-1030
Mailing Address - Country:US
Mailing Address - Phone:806-826-5581
Mailing Address - Fax:
Practice Address - Street 1:PARKVIEW HOSPITAL
Practice Address - Street 2:901 SWEETWATER ST
Practice Address - City:WHEELER
Practice Address - State:TX
Practice Address - Zip Code:79096-1030
Practice Address - Country:US
Practice Address - Phone:806-826-5581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5779207L00000X, 207P00000X, 207Q00000X
NV8453207L00000X
AZ31909207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVC23540Medicare UPIN
NVWQBHV30483Medicare PIN