Provider Demographics
NPI:1407202443
Name:RILES WILLIAMS, TWANNA (RN BSN)
Entity Type:Individual
Prefix:
First Name:TWANNA
Middle Name:
Last Name:RILES WILLIAMS
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13602 LAKE MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-5694
Mailing Address - Country:US
Mailing Address - Phone:281-507-9281
Mailing Address - Fax:
Practice Address - Street 1:13602 LAKE MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-5694
Practice Address - Country:US
Practice Address - Phone:281-507-9281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX607816163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management