MEDICARE: LISA DIANE WILLIAMS RPH

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	183500000X	Pharmacist	37157	TX

General Provider Information

NPI Number	:	1457640450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA DIANE WILLIAMS RPH

Provider Business Mailing Address
First Line	:	108 WAKE LN
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78633-2257
Country	:	US
Telephone Number	:	512-809-1332
Fax Number	:

Provider Business Practice Location Address
First Line	:	1513 E NEW HOPE DR BLDG E
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78641-5760
Country	:	US
Telephone Number	:	512-219-0724
Fax Number	:

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

Provider Enumeration Date	:	03/31/2011
Last Update Date	:	03/14/2025

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