MEDICARE: MS. TANYA EVETTE WILLIAMS B.S.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	634769	TX

General Provider Information

NPI Number	:	1407868516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TANYA EVETTE WILLIAMS B.S.N.

Provider Business Mailing Address
First Line	:	1315 ESTHER DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77088-6022
Country	:	US
Telephone Number	:	713-791-1414
Fax Number	:	713-956-0227

Provider Business Practice Location Address
First Line	:	1315 ESTHER DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77088-6022
Country	:	US
Telephone Number	:	713-791-1414
Fax Number	:	713-956-0227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	07/08/2007

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