Provider Demographics
NPI:1720809205
Name:JONES WILLIAMS, VICKIE D
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:D
Last Name:JONES WILLIAMS
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:PO BOX 840888
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77284-0888
Mailing Address - Country:US
Mailing Address - Phone:281-578-1205
Mailing Address - Fax:281-931-4429
Practice Address - Street 1:515 N SAM HOUSTON PKWY E STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4000
Practice Address - Country:US
Practice Address - Phone:281-578-1205
Practice Address - Fax:281-931-4429
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX690343171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator