Provider Demographics
NPI:1356366033
Name:WILLIAMS, LAKISHA SANDRA (DC)
Entity type:Individual
Prefix:DR
First Name:LAKISHA
Middle Name:SANDRA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LAKISHA
Other - Middle Name:SANDRA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:5506 IMPERIAL WOOD CT
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-2095
Mailing Address - Country:US
Mailing Address - Phone:281-431-1618
Mailing Address - Fax:
Practice Address - Street 1:5506 IMPERIAL WOOD CT
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-2095
Practice Address - Country:US
Practice Address - Phone:281-431-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor