Provider Demographics
NPI:1811407760
Name:WILLIAMS, EZZARD CHARLES (LCDC)
Entity Type:Individual
Prefix:
First Name:EZZARD
Middle Name:CHARLES
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 HARWIN DR STE 280
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2139
Mailing Address - Country:US
Mailing Address - Phone:832-271-5101
Mailing Address - Fax:844-607-0730
Practice Address - Street 1:7011 HARWIN DR STE 280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2139
Practice Address - Country:US
Practice Address - Phone:832-271-5101
Practice Address - Fax:844-607-0730
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10896101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00071008OtherDRIVERS LICENSE