Provider Demographics
NPI:1740661826
Name:WILLIAMS HEALTH, PLLC
Entity type:Organization
Organization Name:WILLIAMS HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:385-335-0928
Mailing Address - Street 1:6336 FRANKLIN GATE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-8166
Mailing Address - Country:US
Mailing Address - Phone:385-335-0928
Mailing Address - Fax:
Practice Address - Street 1:210 THUNDERBIRD DR STE X1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3927
Practice Address - Country:US
Practice Address - Phone:915-581-4440
Practice Address - Fax:915-581-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30688122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty