Provider Demographics
NPI:1881628238
Name:WILLIAMS, STORMEE (MD)
Entity type:Individual
Prefix:DR
First Name:STORMEE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215-3239
Mailing Address - Country:US
Mailing Address - Phone:469-227-2700
Mailing Address - Fax:469-227-2701
Practice Address - Street 1:1600 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-3239
Practice Address - Country:US
Practice Address - Phone:469-227-2700
Practice Address - Fax:469-227-2701
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4658208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190223101Medicaid
TX190223101Medicaid