Healthcare Provider Details

I. General information

NPI: 1558810473
Provider Name (Legal Business Name): SARA BETH WILLIAMSON APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 STATE HWY 6 S
COLLEGE STATION TX
77845
US

IV. Provider business mailing address

2800 S TEXAS AVE SUITE 202
BRYAN TX
77802-5361
US

V. Phone/Fax

Practice location:
  • Phone: 979-731-5200
  • Fax: 979-731-5210
Mailing address:
  • Phone: 979-774-2060
  • Fax: 979-776-5814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP132110
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: