Provider Demographics
NPI:1649602020
Name:WILLIAMS, SEKIBO R (SA C)
Entity Type:Individual
Prefix:
First Name:SEKIBO
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:SA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8619 MAGNOLIA FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6956
Mailing Address - Country:US
Mailing Address - Phone:281-937-1600
Mailing Address - Fax:
Practice Address - Street 1:8619 MAGNOLIA FOREST DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6956
Practice Address - Country:US
Practice Address - Phone:281-937-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant