Provider Demographics
NPI:1083752661
Name:WILLIAMS, MARGARET SMART (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:SMART
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 HOLTON ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2813
Mailing Address - Country:US
Mailing Address - Phone:281-546-6438
Mailing Address - Fax:713-664-9051
Practice Address - Street 1:810 HOLTON ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2813
Practice Address - Country:US
Practice Address - Phone:281-546-6438
Practice Address - Fax:713-664-9051
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1051670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0630006Medicaid
TX82330TOtherBLUECROSSBLUESHIELD
S56155Medicare UPIN
TX650474Medicare ID - Type Unspecified