Provider Demographics
NPI:1073663837
Name:WILLIAMS, SHIRLEY HOLLY (DMD)
Entity type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:HOLLY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SHIRLEY
Other - Middle Name:THARWAT
Other - Last Name:HAMAMCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:12920 W PARMER LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-410-7774
Mailing Address - Fax:
Practice Address - Street 1:12920 W PARMER LN
Practice Address - Street 2:SUITE 101
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-410-7774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice