Provider Demographics
NPI:1487984290
Name:WILLIAMS, ABIOLA ELFREIDA (APRN, GNP-BC)
Entity type:Individual
Prefix:
First Name:ABIOLA
Middle Name:ELFREIDA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN, GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1494
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77487-1494
Mailing Address - Country:US
Mailing Address - Phone:713-253-1549
Mailing Address - Fax:713-758-0273
Practice Address - Street 1:5319 MARBLE CREEK LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4663
Practice Address - Country:US
Practice Address - Phone:713-253-1549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX710778363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX213935401Medicaid
TX213935401Medicaid