Provider Demographics
NPI:1629490834
Name:WILLIAMS, VICTORIA NKIRU (FNP-BC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:NKIRU
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77023-3548
Mailing Address - Country:US
Mailing Address - Phone:713-831-6554
Mailing Address - Fax:713-535-2554
Practice Address - Street 1:4600 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-3548
Practice Address - Country:US
Practice Address - Phone:713-522-3976
Practice Address - Fax:404-494-7435
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124872363LF0000X
TX699761163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX339488402Medicaid