Provider Demographics
NPI:1174041248
Name:WILLIAMS, CHERISE DAVENA
Entity Type:Individual
Prefix:
First Name:CHERISE
Middle Name:DAVENA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20834 COCHRAN RD
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:TX
Mailing Address - Zip Code:77445-8510
Mailing Address - Country:US
Mailing Address - Phone:936-218-9014
Mailing Address - Fax:
Practice Address - Street 1:20834 COCHRAN RD
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:TX
Practice Address - Zip Code:77445-8510
Practice Address - Country:US
Practice Address - Phone:936-218-9014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health