Provider Demographics
NPI:1336329853
Name:WILLIAMS, VIRGINIA E (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 E OVILLA RD
Mailing Address - Street 2:BOX 300
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-2607
Mailing Address - Country:US
Mailing Address - Phone:214-265-7771
Mailing Address - Fax:214-219-1098
Practice Address - Street 1:269 E OVILLA RD
Practice Address - Street 2:BOX 300
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-2607
Practice Address - Country:US
Practice Address - Phone:972-576-3603
Practice Address - Fax:972-576-3664
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23603122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191110901Medicaid
TX191110902Medicaid