Provider Demographics
NPI:1831491208
Name:WILLIAMS LEGACY UNLIMITED LLC
Entity Type:Organization
Organization Name:WILLIAMS LEGACY UNLIMITED LLC
Other - Org Name:ALLIANCE PHARM D
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-591-0900
Mailing Address - Street 1:13734 SH FM 249
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086
Mailing Address - Country:US
Mailing Address - Phone:281-591-0900
Mailing Address - Fax:281-591-0907
Practice Address - Street 1:13734 SH FM 249
Practice Address - Street 2:SUITE C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086
Practice Address - Country:US
Practice Address - Phone:281-591-0900
Practice Address - Fax:281-591-0907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX273693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5901740OtherNCPDP PROVIDER IDENTIFICATION NUMBER