Basic Information
| Provider Information | |||||||||
| NPI: | 1932137379 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | TEARANI | ||||||||
| MiddleName: | J | ||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 6500 SIERRA DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750392480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724435300 | ||||||||
| FaxNumber: | 9724320498 | ||||||||
| Practice Location | |||||||||
| Address1: | 6500 SIERRA DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750392480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724435300 | ||||||||
| FaxNumber: | 9724320498 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 09/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 09/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | E2015 | AR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | N3388 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 203688103 | 05 | TX | MEDICAID | 209810103 | 05 | TX | MEDICAID | 203688101 | 05 | TX | MEDICAID | 135546001 | 05 | AR | MEDICAID |