Provider Demographics
NPI:1366680316
Name:WILLIAMS, LEQUITA ANTOINETTE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:LEQUITA
Middle Name:ANTOINETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 DUNVALE RD
Mailing Address - Street 2:APT 7310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-4451
Mailing Address - Country:US
Mailing Address - Phone:215-681-8044
Mailing Address - Fax:
Practice Address - Street 1:6701 PINEMONT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-3132
Practice Address - Country:US
Practice Address - Phone:281-379-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019500225100000X
TX1188573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist