Provider Demographics
NPI:1093191710
Name:WILLIAMS, DAMIEN SR (RN)
Entity Type:Individual
Prefix:
First Name:DAMIEN
Middle Name:
Last Name:WILLIAMS
Suffix:SR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4014 WILBURN RANCH DR
Mailing Address - Street 2:
Mailing Address - City:MONT BELVIEU
Mailing Address - State:TX
Mailing Address - Zip Code:77523-4208
Mailing Address - Country:US
Mailing Address - Phone:832-647-9372
Mailing Address - Fax:713-583-1825
Practice Address - Street 1:4014 WILBURN RANCH DR
Practice Address - Street 2:
Practice Address - City:MONT BELVIEU
Practice Address - State:TX
Practice Address - Zip Code:77523-4208
Practice Address - Country:US
Practice Address - Phone:832-647-9372
Practice Address - Fax:713-583-1825
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX811280163WP0200X, 163WG0000X, 163WH0200X, 163WM0705X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine