Provider Demographics
NPI:1275898405
Name:WILLIAMS, PEGGY W (NP-C)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:W
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10375 RICHMOND AVE
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4143
Mailing Address - Country:US
Mailing Address - Phone:281-870-1000
Mailing Address - Fax:
Practice Address - Street 1:10375 RICHMOND AVE
Practice Address - Street 2:SUITE 1700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4143
Practice Address - Country:US
Practice Address - Phone:281-870-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX746130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily