Provider Demographics
NPI:1417416009
Name:WILLIAMS, DWIGHT ANDERS (MED, LPC)
Entity Type:Individual
Prefix:MR
First Name:DWIGHT
Middle Name:ANDERS
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12112 GALLEON POINT DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1645
Mailing Address - Country:US
Mailing Address - Phone:832-372-0090
Mailing Address - Fax:
Practice Address - Street 1:7151 OFFICE CITY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-2746
Practice Address - Country:US
Practice Address - Phone:832-431-4246
Practice Address - Fax:832-431-4247
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional