Provider Demographics
NPI:1477255636
Name:WILLIAMS, SURELY NAE MCDADE
Entity Type:Individual
Prefix:MS
First Name:SURELY
Middle Name:NAE MCDADE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 W TIDWELL RD APT 608
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-2369
Mailing Address - Country:US
Mailing Address - Phone:281-630-5332
Mailing Address - Fax:
Practice Address - Street 1:6200 W TIDWELL RD APT 608
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-2369
Practice Address - Country:US
Practice Address - Phone:281-630-5332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty