Provider Demographics
NPI:1033381785
Name:WILLIAMSON, DIANA LYNN (RPH)
Entity Type:Individual
Prefix:MISS
First Name:DIANA
Middle Name:LYNN
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:DR
Other - First Name:DIANA
Other - Middle Name:LYNN
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 772
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75494-0772
Mailing Address - Country:US
Mailing Address - Phone:972-616-3447
Mailing Address - Fax:
Practice Address - Street 1:3213 GREENWAY LN
Practice Address - Street 2:
Practice Address - City:MELISSA
Practice Address - State:TX
Practice Address - Zip Code:75454-3310
Practice Address - Country:US
Practice Address - Phone:972-616-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24626183500000X, 183500000X
PARP438982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist