Provider Demographics
NPI:1215450002
Name:WILLIAMS, PATRICIA DENISE
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DENISE
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 1:23702 FM 1093 1004
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406
Mailing Address - Country:US
Mailing Address - Phone:832-931-5037
Mailing Address - Fax:
Practice Address - Street 1:23702 FM 1093 RD APT 1004
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-7852
Practice Address - Country:US
Practice Address - Phone:832-931-5037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXGMR00107779OtherMEDICAL RADIOLOGY TECHNOLOGIST