Provider Demographics
NPI:1952501447
Name:WILLIAMS, LILLIAN E (PA-C)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:ELAINE
Other - Last Name:EMERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2101 S CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1294
Mailing Address - Country:US
Mailing Address - Phone:956-687-7896
Mailing Address - Fax:956-687-2297
Practice Address - Street 1:2101 S CYNTHIA ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-687-7896
Practice Address - Fax:956-687-2297
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1077607363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA05337OtherLICENSE
TX190946704Medicaid
TX1952501447OtherNPI
TX504737ZUQAOtherMEDICARE PROVIDER NUMBER