Provider Demographics
NPI:1871856443
Name:WILLIAMS, HENRY CLAY
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:CLAY
Last Name:WILLIAMS
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 1:2316 ORANGE ST.
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701
Mailing Address - Country:US
Mailing Address - Phone:409-363-1237
Mailing Address - Fax:409-838-6275
Practice Address - Street 1:2316 ORANGE ST.
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701
Practice Address - Country:US
Practice Address - Phone:409-363-1237
Practice Address - Fax:409-838-6275
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251300000XAgenciesLocal Education Agency (LEA)
No251F00000XAgenciesHome Infusion
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care