Provider Demographics
NPI:1881833598
Name:WILLIAMS, KIMBERLY RAYE
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:RAYE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20919 BIRNAMWOOD BLVD
Mailing Address - Street 2:APT 117#
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338
Mailing Address - Country:US
Mailing Address - Phone:832-397-9129
Mailing Address - Fax:281-344-6014
Practice Address - Street 1:23403 CANYON LAKE DR.
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:832-397-9129
Practice Address - Fax:281-344-6014
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion