Provider Demographics
NPI:1932364981
Name:WILLIAMS, MARISSA MENDRYGAL (AUD)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:MENDRYGAL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:MARISSA
Other - Middle Name:B
Other - Last Name:MENDRYGAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:14634 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-7517
Mailing Address - Country:US
Mailing Address - Phone:281-741-7295
Mailing Address - Fax:
Practice Address - Street 1:14634 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-7517
Practice Address - Country:US
Practice Address - Phone:281-741-7295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 2615231H00000X
TX80215231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist