Provider Demographics
NPI:1821032269
Name:WILLIAMS-DIGGINS, DAWN MARIE (DPM)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:WILLIAMS-DIGGINS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 PAINTED TRL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3247
Mailing Address - Country:US
Mailing Address - Phone:972-658-0626
Mailing Address - Fax:
Practice Address - Street 1:1331 W GRAND PKWY N STE 145
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2736
Practice Address - Country:US
Practice Address - Phone:832-436-0531
Practice Address - Fax:800-652-8206
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADPM.PD286R213E00000X
TX1875213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1567892Medicaid
TX8L2681Medicare PIN
LA5H194Medicare ID - Type Unspecified