Provider Demographics
NPI:1528607561
Name:WILLIAMSON, ROBIN ANNE
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANNE
Last Name:WILLIAMSON
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 1:15604 FM 14
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75706-2821
Mailing Address - Country:US
Mailing Address - Phone:903-593-5537
Mailing Address - Fax:
Practice Address - Street 1:113 NNW LOOP 323
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-8725
Practice Address - Country:US
Practice Address - Phone:903-593-5369
Practice Address - Fax:903-593-3490
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-21
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist