Provider Demographics
NPI:1104122852
Name:WILLIAMS, SANDRA J (LM)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 TIMBERWOLF DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-2106
Mailing Address - Country:US
Mailing Address - Phone:915-565-0122
Mailing Address - Fax:
Practice Address - Street 1:5000 TIMBERWOLF DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2106
Practice Address - Country:US
Practice Address - Phone:915-565-0122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97005175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay