Provider Demographics
NPI:1164635199
Name:WILLIAMSON, JOSEPHINE EVELYN (PT)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:EVELYN
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JO
Other - Middle Name:
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:2509 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-2640
Mailing Address - Country:US
Mailing Address - Phone:409-982-8265
Mailing Address - Fax:
Practice Address - Street 1:8700 9TH AVE
Practice Address - Street 2:STE 103
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8030
Practice Address - Country:US
Practice Address - Phone:409-722-5437
Practice Address - Fax:409-722-5435
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1008324225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist