Provider Demographics
NPI:1992857429
Name:WILLIAMS, LOIS SMITH
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:SMITH
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 1:1608 E BETHANY DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-5851
Mailing Address - Country:US
Mailing Address - Phone:972-442-7898
Mailing Address - Fax:972-442-6192
Practice Address - Street 1:1608 E BETHANY DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-5851
Practice Address - Country:US
Practice Address - Phone:972-442-7898
Practice Address - Fax:972-442-6192
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4954200001Medicare NSC