Provider Demographics
NPI:1427575919
Name:WILLIAMS, CHARLOTTE UTINE (PROVIDER)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:UTINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 NORWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-2278
Mailing Address - Country:US
Mailing Address - Phone:214-213-6746
Mailing Address - Fax:972-863-7394
Practice Address - Street 1:928 NORWOOD LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-2278
Practice Address - Country:US
Practice Address - Phone:214-213-6746
Practice Address - Fax:972-863-7394
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)