Provider Demographics
NPI:1184604191
Name:WILLIAMS, RENEE ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:ELIZABETH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S LOOP 336 W
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3302
Mailing Address - Country:US
Mailing Address - Phone:936-539-4500
Mailing Address - Fax:936-539-4050
Practice Address - Street 1:4875 ALTAMA AVE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-2912
Practice Address - Country:US
Practice Address - Phone:912-554-0010
Practice Address - Fax:912-554-0075
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8123-T152W00000X
GAOPT002279152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA786573174BMedicaid
GA786573174AMedicaid
GAP00294702OtherRR MEDICARE
GAP00294702OtherRR MEDICARE
GA786573174BMedicaid