Provider Demographics
NPI:1376087767
Name:MICHAEL J. WILLIAMSON, P.C.
Entity Type:Organization
Organization Name:MICHAEL J. WILLIAMSON, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:713-304-3576
Mailing Address - Street 1:10011 CEDARHURST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-5102
Mailing Address - Country:US
Mailing Address - Phone:713-304-3576
Mailing Address - Fax:
Practice Address - Street 1:4101 GREENBRIAR ST
Practice Address - Street 2:SUITE 105F
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5294
Practice Address - Country:US
Practice Address - Phone:713-304-3576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55618261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health