Provider Demographics
NPI:1720083256
Name:WILLIAMS, THOMAS FORD (DDS)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:FORD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-5013
Mailing Address - Country:US
Mailing Address - Phone:409-838-9983
Mailing Address - Fax:409-833-2550
Practice Address - Street 1:695 18TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-5013
Practice Address - Country:US
Practice Address - Phone:409-838-9983
Practice Address - Fax:409-833-2550
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167769OtherUNITED CONCORDIA INSURANC