Provider Demographics
NPI:1174505838
Name:WILLIAMS, DIANA (RNC, WHMP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RNC, WHMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 ARION PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2880
Mailing Address - Country:US
Mailing Address - Phone:210-349-9300
Mailing Address - Fax:210-366-2558
Practice Address - Street 1:12709 TOEPPERWEIN RD
Practice Address - Street 2:SUITE 309
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3258
Practice Address - Country:US
Practice Address - Phone:210-657-4099
Practice Address - Fax:210-599-9137
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXWIL-0429-7169363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXWIL-0429-7169OtherNCC ID