Provider Demographics
NPI:1437459104
Name:KELCEY L WILLIAMS MD PLLC
Entity Type:Organization
Organization Name:KELCEY L WILLIAMS MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RENDERING PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELCEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-407-1230
Mailing Address - Street 1:1707 1/2 POST OAK BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3801
Mailing Address - Country:US
Mailing Address - Phone:361-407-1230
Mailing Address - Fax:
Practice Address - Street 1:2121 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2153
Practice Address - Country:US
Practice Address - Phone:361-407-1230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7926208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty