Provider Demographics
NPI:1306109947
Name:WILLIAMS, DANA KIM
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:KIM
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 1:19811 CYPRESSWOOD SHR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-3020
Mailing Address - Country:US
Mailing Address - Phone:409-363-1235
Mailing Address - Fax:281-719-8943
Practice Address - Street 1:19811 CYPRESSWOOD SHR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-3020
Practice Address - Country:US
Practice Address - Phone:409-363-1235
Practice Address - Fax:281-719-8943
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251300000XAgenciesLocal Education Agency (LEA)
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251V00000XAgenciesVoluntary or Charitable
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care