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NPI Code Detail

MEDICARE: NICOLE MARIE WILLIAMS

MEDICARE: NICOLE MARIE WILLIAMS
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
1124Q00000XDental Hygienist22202TX

General Provider Information

NPI Number : 1932684834
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE MARIE WILLIAMS
Provider Business Mailing Address
First Line : 3438 ROLGOM PLACE CT
Second Line :
City : HOUSTON
State : TX
Zip : 77021-6020
Country : US
Telephone Number : 210-388-3101
Fax Number :
Provider Business Practice Location Address
First Line : 2400 MID LN STE 350
Second Line :
City : HOUSTON
State : TX
Zip : 77027-4466
Country : US
Telephone Number : 713-714-4245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2018
Last Update Date : 09/27/2018

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Directions to “ NICOLE MARIE WILLIAMS ” Practice Location

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