Provider Demographics
NPI:1073940466
Name:WILLIAMS, DANA (DPT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 CRENSHAW RD
Mailing Address - Street 2:BUILDING D100
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3094
Mailing Address - Country:US
Mailing Address - Phone:713-943-1100
Mailing Address - Fax:713-943-1178
Practice Address - Street 1:5150 CRENSHAW RD
Practice Address - Street 2:BUILDING D100
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3094
Practice Address - Country:US
Practice Address - Phone:713-943-1100
Practice Address - Fax:713-943-1178
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3114272225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist