Provider Demographics
NPI:1902855794
Name:WILLIAMS, AMY H (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:H
Last Name:WILLIAMS
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 1:3107 BAY RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4982
Mailing Address - Country:US
Mailing Address - Phone:706-833-8712
Mailing Address - Fax:
Practice Address - Street 1:3107 BAY RIDGE CT
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4982
Practice Address - Country:US
Practice Address - Phone:706-833-8712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24876207P00000X
TXN4842207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1902855794OtherTRICARE SOUTH
TX8CE254OtherBCBS TX
P00410867OtherRAILROAD MEDICARE
TX208104401Medicaid
TX1902855794OtherBCBSTX
GA218875878AMedicaid
SC248761Medicaid
P00410867OtherRAILROAD MEDICARE
SC248761Medicaid
GA93BFDCRMedicare PIN
TX1902855794OtherTRICARE SOUTH
TX8L22385Medicare PIN