Provider Demographics
NPI:1821286568
Name:WILLIAMS, CARLISS D (RN)
Entity Type:Individual
Prefix:
First Name:CARLISS
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-796-2001
Mailing Address - Fax:713-796-0270
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 2001
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-796-2001
Practice Address - Fax:713-796-0270
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX724563163WX0601X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0601XNursing Service ProvidersRegistered NurseOtorhinolaryngology & Head-Neck