Healthcare Provider Details

I. General information

NPI: 1396763447
Provider Name (Legal Business Name): RACHEL H WILLIAMS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N US HIGHWAY 87
BIG SPRING TX
79720-0283
US

IV. Provider business mailing address

1901 N US HIGHWAY 87
BIG SPRING TX
79720-0283
US

V. Phone/Fax

Practice location:
  • Phone: 432-267-8216
  • Fax:
Mailing address:
  • Phone: 432-267-8216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA04309
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: