Provider Demographics
NPI:1851080865
Name:SEMIEN, WILLIE MARCUS
Entity Type:Individual
Prefix:
First Name:WILLIE
Middle Name:MARCUS
Last Name:SEMIEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11406 CARSON FIELD LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2292
Mailing Address - Country:US
Mailing Address - Phone:832-729-2244
Mailing Address - Fax:
Practice Address - Street 1:11406 CARSON FIELD LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2292
Practice Address - Country:US
Practice Address - Phone:832-729-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17532798343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)