Provider Demographics
NPI:1427846542
Name:WILLIAMS, TEVIN
Entity type:Individual
Prefix:
First Name:TEVIN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 PLAZA BLVD APT 547
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4165
Mailing Address - Country:US
Mailing Address - Phone:917-771-2153
Mailing Address - Fax:
Practice Address - Street 1:2323 PLAZA BLVD APT 547
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4165
Practice Address - Country:US
Practice Address - Phone:917-771-2153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No171M00000XOther Service ProvidersCase Manager/Care Coordinator