DR. RICHARD KENNETH WILLMS M.D. NPI 1629087663

NPI Information

  • NPI: 1629087663
  • Provider Name: DR. RICHARD KENNETH WILLMS, M.D.
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 14565 CR 1113
    TYLER, TX
    ZIP 75703
  • Phone: (903) 595-3728

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NPI Details

DR. Richard Kenneth Willms, M.D. is a vascular surgery surgery in Tyler, TX. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. DR. Richard Kenneth Willms, M.D. NPI is 1629087663. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

14565 CR 1113
TYLER, TX
ZIP 75703-551
Phone: (903) 595-3728
Fax: (903) 595-0333

The NPI 1629087663 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/7/2006 and was last updated on 7/23/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)C8691TEXASNo
22086S0129XSurgeryVascular SurgeryC8691TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100E069MEDICARE PIN
2C23599MEDICARE OSCAR/CERTIFICATIONTEXAS
300E069MEDICARE UPINTEXAS
4C23599MEDICARE UPIN
5110137001MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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