Provider Demographics
NPI:1346721107
Name:WILLIAMS, SHARON GOODSON (LVN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:GOODSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 SAND FLAT RD
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:TX
Mailing Address - Zip Code:75946-5534
Mailing Address - Country:US
Mailing Address - Phone:936-347-2580
Mailing Address - Fax:
Practice Address - Street 1:136 SAND FLAT RD
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:TX
Practice Address - Zip Code:75946-5534
Practice Address - Country:US
Practice Address - Phone:936-347-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX153224164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse