Provider Demographics
NPI:1891760575
Name:WILLIAMS-WATSON, KIMBERLY DENISE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:DENISE
Last Name:WILLIAMS-WATSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11303 BENTGROVE LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2855
Mailing Address - Country:US
Mailing Address - Phone:832-220-9262
Mailing Address - Fax:
Practice Address - Street 1:15322 COPPER GROVE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2293
Practice Address - Country:US
Practice Address - Phone:281-859-7596
Practice Address - Fax:832-674-4253
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2137208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX039094003Medicaid
TX039094002Medicaid
1366623845OtherNPI