DR. RICHARD KENNETH WILLMS (NPI# 1629087663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629087663 |
| Entity Type | Individual |
| Full Name | DR. RICHARD KENNETH WILLMS |
| Credential | M.D. |
| Practice Address |
14565 Cr 1113 Tyler TX 75703-9551 |
| Practice Telephone | 9035953728 |
| Practice Fax Number | 9035950333 |
| Mailing Telephone | 9035953728 |
| Mailing Fax Number | 9035950333 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2015-07-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
C8691 | TX | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | C8691 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 110137001 | 05 |
| Street Address |
14565 CR 1113 |
| City | TYLER |
| State | TX |
| Zip Code | 75703-9551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245456375 | Mark Robbins Md Pa | Surgery | 1040 S Fleishel Ave Ste 1, Tyler, TX 75701-2031 | 2007-04-17 |
| 1235667650 | Erica Denise Stegall | Surgery | 1040 S Fleishel Ave, Tyler, TX 75701-2031 | 2017-05-30 |
| 1245650183 | Roy Wesley Jones | Surgery | 619 S Fleishel Ave Ste 203, Tyler, TX 75701-2067 | 2014-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482003 | Endovascular Lab Pllc | Surgery | 612 N Washington Avenue, Suite 100, Odessa, TX 79761 | 2020-03-16 |
| 1356980163 | Jeffrey M. Martinez, M.d., P.a. | Surgery | 525 Centre Oak Drive, Suite 140, San Antonio, TX 78258 | 2019-12-26 |
| 1245875061 | Usa Vascular Center of Dallas Pllc | Surgery | 2300 W Fm 544 Ste B, Wylie, TX 75098-4931 | 2019-11-15 |
| 1740830959 | Coastal Plains Endeavors LLC | Surgery | 1602 E Houston St Ste A, Beeville, TX 78102-5335 | 2019-09-19 |
| 1205488632 | Usa Vein Clinics of Dallas Pllc | Surgery | 3128 Forest Ln Ste 320, Dallas, TX 75234-7761 | 2019-07-16 |
| 1558922625 | Sudad Kareem Al Hadad | Surgery | 12579 Richmond Ave Ste 800, Houston, TX 77082-2555 | 2019-06-27 |
| 1043782907 | Timothy C. Pringle Md Pa | Surgery | 4541 N. Josey Lane, Suite 140, Carrollton, TX 75010 | 2018-12-17 |
| 1518449701 | Kenton Lee Rommens | Surgery | 6400 Fannin St. Suite 2850, Houston, TX 77030 | 2018-09-04 |
| 1336633999 | Total Vein Treatment Centers | Surgery | 2301 Marsh Ln Ste 210, Plano, TX 75093-8497 | 2018-06-18 |
| 1508384652 | Jcm Vein Pllc Vein Care Coastal Bend | Surgery | 3301 S Alameda St Ste 402, Corpus Christi, TX 78411-1882 | 2017-09-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.