Provider Demographics
NPI:1639128085
Name:WILLIAMS, DANIEL LEE
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:LEE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12870 E. FM 917
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALVARADO
Mailing Address - State:TX
Mailing Address - Zip Code:76009
Mailing Address - Country:US
Mailing Address - Phone:817-473-7564
Mailing Address - Fax:817-473-7413
Practice Address - Street 1:12870 E FM 917
Practice Address - Street 2:SUITE C
Practice Address - City:ALVARADO
Practice Address - State:TX
Practice Address - Zip Code:76009-5163
Practice Address - Country:US
Practice Address - Phone:817-473-7564
Practice Address - Fax:817-473-7413
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0089158171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor