Provider Demographics
NPI:1770992364
Name:WILLIAMS, LEO JOSEPH JR
Entity type:Individual
Prefix:DR
First Name:LEO
Middle Name:JOSEPH
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11726 LEGEND MANOR DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-3076
Mailing Address - Country:US
Mailing Address - Phone:291-759-7889
Mailing Address - Fax:281-759-7889
Practice Address - Street 1:11726 LEGEND MANOR DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-3076
Practice Address - Country:US
Practice Address - Phone:291-759-7889
Practice Address - Fax:281-759-7889
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC6553207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology