Provider Demographics
NPI:1093294639
Name:WILLIAMS-VASQUEZ, YOLANDA (LVN)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:WILLIAMS-VASQUEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 W BELLFORT AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-5035
Mailing Address - Country:US
Mailing Address - Phone:210-744-0711
Mailing Address - Fax:210-340-1259
Practice Address - Street 1:3131 W BELLFORT AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:210-744-0711
Practice Address - Fax:210-340-1259
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX330076164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173913801Medicaid