Provider Demographics
NPI:1881790913
Name:WILLIAMS, EMILY D (PA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3051 CHURCHILL DR STE 130
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2710
Mailing Address - Country:US
Mailing Address - Phone:972-539-0086
Mailing Address - Fax:972-355-9680
Practice Address - Street 1:3051 CHURCHILL DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2713
Practice Address - Country:US
Practice Address - Phone:972-539-0086
Practice Address - Fax:972-355-9680
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA02524363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ60168Medicare UPIN
TX8K6116Medicare PIN