Provider Demographics
NPI:1386745982
Name:WILLIAMS, LUCIA LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:LEIGH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 NACOGDOCHES STREET
Mailing Address - Street 2:SUITE 340
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-2444
Mailing Address - Country:US
Mailing Address - Phone:903-586-8100
Mailing Address - Fax:903-589-3791
Practice Address - Street 1:203 NACOGDOCHES STREET
Practice Address - Street 2:SUITE 340
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-2444
Practice Address - Country:US
Practice Address - Phone:903-586-8100
Practice Address - Fax:903-589-3791
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9013207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J0340OtherBCBS PROVIDER ID
TXP00603174OtherMEDICARE RAILROAD PIN
TX117029OtherSUPERIOR ID
TX031608503Medicaid
TX8B8010Medicare PIN
TX031608503Medicaid