Provider Demographics
NPI:1154701795
Name:WILLIAMS, BARUCH LAVERNE
Entity type:Individual
Prefix:DR
First Name:BARUCH
Middle Name:LAVERNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8022 GARDEN PARKS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4635
Mailing Address - Country:US
Mailing Address - Phone:713-309-0206
Mailing Address - Fax:
Practice Address - Street 1:8022 GARDEN PARKS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4635
Practice Address - Country:US
Practice Address - Phone:713-309-0206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36506103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical