Provider Demographics
NPI:1689732828
Name:WILLIAMS, AMY M
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:TX
Mailing Address - Zip Code:76531
Mailing Address - Country:US
Mailing Address - Phone:254-386-8766
Mailing Address - Fax:254-389-8326
Practice Address - Street 1:615 E MAIN
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:TX
Practice Address - Zip Code:76531
Practice Address - Country:US
Practice Address - Phone:254-386-8766
Practice Address - Fax:254-386-8326
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0072429174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4988690001Medicare ID - Type Unspecified