Provider Demographics
NPI:1528264348
Name:WILLIAMS, YOLANDA DENISE (PA)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1450 EMPIRE CENTRAL DRIVE
Mailing Address - Street 2:STE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4081
Mailing Address - Country:US
Mailing Address - Phone:214-905-5000
Mailing Address - Fax:214-905-5000
Practice Address - Street 1:850 CENTRAL PKWY E
Practice Address - Street 2:STE 275
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074
Practice Address - Country:US
Practice Address - Phone:972-881-4688
Practice Address - Fax:855-668-1010
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA05027363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186023101Medicaid
TX8Y2614OtherBCBS
TX186023101Medicaid