MEDICARE: DR. TERESA RENEE WILLIAMS M.D.

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	208D00000X	General Practice Physician	N9984	TX

General Provider Information

NPI Number	:	1699901645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERESA RENEE WILLIAMS M.D.

Provider Business Mailing Address
First Line	:	3511 ENGLEWOOD DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-9189
Country	:	US
Telephone Number	:	866-713-3776
Fax Number	:	866-713-3776

Provider Business Practice Location Address
First Line	:	800 WILCREST DR
Second Line	:	SUITE 204
City	:	HOUSTON
State	:	TX
Zip	:	77042-6301
Country	:	US
Telephone Number	:	866-713-3776
Fax Number	:	866-713-3776

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

Provider Enumeration Date	:	06/04/2009
Last Update Date	:	10/08/2015

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