Provider Demographics
NPI:1831257492
Name:WILLIAMS-ANDERSON, SHAWANDA (PH D)
Entity type:Individual
Prefix:DR
First Name:SHAWANDA
Middle Name:
Last Name:WILLIAMS-ANDERSON
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:SHAWANDA
Other - Middle Name:ANN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PH D
Mailing Address - Street 1:8300 CYPRESS CREEK PKWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5654
Mailing Address - Country:US
Mailing Address - Phone:281-890-7776
Mailing Address - Fax:281-890-7785
Practice Address - Street 1:8300 CYPRESS CREEK PKWY
Practice Address - Street 2:SUITE 450
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5654
Practice Address - Country:US
Practice Address - Phone:281-890-7776
Practice Address - Fax:281-890-7785
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33380103G00000X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1978520-02Medicaid
TXTXB132210Medicare UPIN