Provider Demographics
NPI:1235201781
Name:WILLIAMSON, ANNETTE JUNE (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:JUNE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANNETTE
Other - Middle Name:JUNE
Other - Last Name:BOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4400 FREDERICKSBURG RD
Mailing Address - Street 2:STE 107
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-1969
Mailing Address - Country:US
Mailing Address - Phone:210-737-1926
Mailing Address - Fax:210-737-2621
Practice Address - Street 1:238 BROOKLEY AVENUE
Practice Address - Street 2:
Practice Address - City:BOLLING AIR FORCE BASE
Practice Address - State:DC
Practice Address - Zip Code:20032-7050
Practice Address - Country:US
Practice Address - Phone:202-767-1868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4227152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist