Provider Demographics
NPI:1639691926
Name:WILLIAMS, DREKA DENISE (OD)
Entity Type:Individual
Prefix:DR
First Name:DREKA
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:3309 FORESTVILLE PL
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-4409
Practice Address - Country:US
Practice Address - Phone:301-420-6610
Practice Address - Fax:301-735-0294
Is Sole Proprietor?:No
Enumeration Date:2017-07-09
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDTA2589152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist