Provider Demographics
NPI:1134867898
Name:WILLIAMS, JERICA LAE'L (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JERICA
Middle Name:LAE'L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21707 KINGSLAND BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2519
Mailing Address - Country:US
Mailing Address - Phone:281-398-8235
Mailing Address - Fax:281-398-8246
Practice Address - Street 1:21707 KINGSLAND BLVD STE 101
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2519
Practice Address - Country:US
Practice Address - Phone:281-398-8235
Practice Address - Fax:281-398-8246
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1359253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist