Provider Demographics
NPI:1740203264
Name:WILLIAMSON, DANNY GRAY (DC)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:GRAY
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 BURKE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1826
Mailing Address - Country:US
Mailing Address - Phone:713-944-1441
Mailing Address - Fax:713-941-2089
Practice Address - Street 1:3219 BURKE RD
Practice Address - Street 2:SUITE B
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1826
Practice Address - Country:US
Practice Address - Phone:713-944-1441
Practice Address - Fax:713-941-2089
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX600869Medicare ID - Type Unspecified
TXT16664Medicare UPIN