Provider Demographics
NPI:1326795477
Name:WILLIAMS, LOIS
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 E ASCENSION ST # 207
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-3028
Mailing Address - Country:US
Mailing Address - Phone:225-228-7497
Mailing Address - Fax:225-243-9757
Practice Address - Street 1:711 E ASCENSION ST # 207
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3028
Practice Address - Country:US
Practice Address - Phone:225-228-7497
Practice Address - Fax:225-243-9757
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver