1578400446 NPI number — WILLIAMS MEDICAL GROUP PRACTICE, LLC

Table of content: MADISON ALEXANDRA CRONE BA (NPI 1396682266)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578400446 NPI number — WILLIAMS MEDICAL GROUP PRACTICE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAMS MEDICAL GROUP PRACTICE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578400446
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 95469
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAPEVINE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76099-9700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-724-0574
Provider Business Mailing Address Fax Number:
405-445-3310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 WALLACE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75006-8006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-724-0574
Provider Business Practice Location Address Fax Number:
405-445-3310
Provider Enumeration Date:
04/30/2026

Additional Information

Authorized Official

Authorized Official Last Name:
PYLE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
WAYNE
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
469-688-0750

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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