Provider Demographics
NPI:1861622730
Name:WILLIAMS, ERIC BRANNON (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:BRANNON
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 1:12801 N CENTRAL EXPY STE 350
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1716
Mailing Address - Country:US
Mailing Address - Phone:214-702-5336
Mailing Address - Fax:972-773-9843
Practice Address - Street 1:12801 N CENTRAL EXPY STE 350
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1716
Practice Address - Country:US
Practice Address - Phone:214-702-5336
Practice Address - Fax:972-773-9843
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP08092084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program