Provider Demographics
NPI:1760088819
Name:WILLIAMS, LAURA KATHERINE (RDN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHERINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:700 E PARK BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5472
Mailing Address - Country:US
Mailing Address - Phone:972-422-9180
Mailing Address - Fax:479-268-3305
Practice Address - Street 1:700 E PARK BLVD STE 206
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5472
Practice Address - Country:US
Practice Address - Phone:972-422-9180
Practice Address - Fax:479-268-3305
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2947462OtherPROLIABILITY BY MERCER