Provider Demographics
NPI:1104179522
Name:WILLIAMS, DEBRA NELL (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:NELL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 PEARL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-3629
Mailing Address - Country:US
Mailing Address - Phone:409-835-8461
Mailing Address - Fax:409-839-2310
Practice Address - Street 1:1225 PEARL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-3629
Practice Address - Country:US
Practice Address - Phone:409-835-8461
Practice Address - Fax:409-839-2310
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2116174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator