Provider Demographics
NPI:1316029713
Name:WILLIAMS, SHAWN K (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:K
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:K
Other - Last Name:MARKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:4705 109TH PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-7323
Mailing Address - Country:US
Mailing Address - Phone:806-702-8511
Mailing Address - Fax:806-702-8511
Practice Address - Street 1:4705 109TH PL
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-7323
Practice Address - Country:US
Practice Address - Phone:806-702-8511
Practice Address - Fax:806-702-8511
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168271801Medicaid