Provider Demographics
NPI:1215579644
Name:WILLIAMS, ALYCE (NP)
Entity Type:Individual
Prefix:
First Name:ALYCE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6407 TANZANITE DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-3325
Mailing Address - Country:US
Mailing Address - Phone:512-964-1037
Mailing Address - Fax:
Practice Address - Street 1:304 S 22ND ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76501-4726
Practice Address - Country:US
Practice Address - Phone:254-298-7000
Practice Address - Fax:254-298-7111
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142806363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health