Provider Demographics
NPI:1750383618
Name:WILLIAMS, MELITA JOYCE (MD)
Entity type:Individual
Prefix:
First Name:MELITA
Middle Name:JOYCE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MELITA
Other - Middle Name:JOYCE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3028 COMMUNICATIONS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8908
Mailing Address - Country:US
Mailing Address - Phone:214-225-6416
Mailing Address - Fax:469-929-9897
Practice Address - Street 1:3028 COMMUNICATIONS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8908
Practice Address - Country:US
Practice Address - Phone:214-225-6416
Practice Address - Fax:469-929-9897
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200657207Q00000X
TXL4176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1706281Medicaid
LAI5601Medicare UPIN
TXTXB161960Medicare PIN
LA1706281Medicaid
TXTXB161955Medicare PIN