Provider Demographics
NPI:1366623845
Name:KIMBERLY WILLIAMS-WATSON, MD
Entity Type:Organization
Organization Name:KIMBERLY WILLIAMS-WATSON, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:MILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-426-3370
Mailing Address - Street 1:1801 NORTH LOOP W
Mailing Address - Street 2:SUITE 45
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1444
Mailing Address - Country:US
Mailing Address - Phone:713-426-3370
Mailing Address - Fax:713-426-3374
Practice Address - Street 1:1801 NORTH LOOP W
Practice Address - Street 2:SUITE 45
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1444
Practice Address - Country:US
Practice Address - Phone:713-426-3370
Practice Address - Fax:713-426-3374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2137261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1891760575OtherNPI
TX039094003Medicaid
TX039094002Medicaid