Provider Demographics
NPI:1518121938
Name:WILLIAMS, MICHELLE MUNN (OD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MUNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:LEE
Other - Last Name:MUNN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-0845
Mailing Address - Country:US
Mailing Address - Phone:972-636-3937
Mailing Address - Fax:972-635-9899
Practice Address - Street 1:7252 FM 35
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-9701
Practice Address - Country:US
Practice Address - Phone:972-636-3937
Practice Address - Fax:972-635-9899
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7221T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist