Provider Demographics
NPI:1932795242
Name:WILLIAMSON FAMILY HEALTH
Entity Type:Organization
Organization Name:WILLIAMSON FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDD
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:936-208-5786
Mailing Address - Street 1:1216 ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3326
Mailing Address - Country:US
Mailing Address - Phone:936-632-6184
Mailing Address - Fax:936-632-7836
Practice Address - Street 1:1216 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3326
Practice Address - Country:US
Practice Address - Phone:936-632-6184
Practice Address - Fax:936-632-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care