Provider Demographics
NPI:1699738054
Name:WILLIAMS, BENJAMIN JOEL (MD)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:JOEL
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6124 W PARKER RD
Mailing Address - Street 2:STE G36
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:972-981-3107
Mailing Address - Fax:972-981-3236
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:STE G36
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-981-3107
Practice Address - Fax:972-981-3236
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5775207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8127B6Medicare PIN
E91021Medicare UPIN