Provider Demographics
NPI:1922570712
Name:WILLIAMS, KATRINA (PROVIDER)
Entity Type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PROVIDER
Other - Prefix:MS
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:STOVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PUREE INC
Mailing Address - Street 1:12214 PLUMPOINT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-3138
Mailing Address - Country:US
Mailing Address - Phone:832-329-3200
Mailing Address - Fax:
Practice Address - Street 1:12214 PLUMPOINT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-3138
Practice Address - Country:US
Practice Address - Phone:832-329-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty