Provider Demographics
NPI:1639676182
Name:WILLIAMS, DANIEL CALEB (RN)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CALEB
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13291 GLADE MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-3538
Mailing Address - Country:US
Mailing Address - Phone:936-446-8419
Mailing Address - Fax:
Practice Address - Street 1:13291 GLADE MEADOW LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77302-3538
Practice Address - Country:US
Practice Address - Phone:936-446-8419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX907312163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse