Provider Demographics
NPI:1881911295
Name:WILLIAMSEN, JOSEPHINE D (RPH)
Entity type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:D
Last Name:WILLIAMSEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 KINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3700
Mailing Address - Country:US
Mailing Address - Phone:281-361-0083
Mailing Address - Fax:281-361-3074
Practice Address - Street 1:4303 KINGWOOD DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3700
Practice Address - Country:US
Practice Address - Phone:281-361-0083
Practice Address - Fax:281-361-3074
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-24
Last Update Date:2010-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist