Healthcare Provider Details

I. General information

NPI: 1407868516
Provider Name (Legal Business Name): TANYA EVETTE WILLIAMS B.S.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 ESTHER DR
HOUSTON TX
77088-6022
US

IV. Provider business mailing address

1315 ESTHER DR
HOUSTON TX
77088-6022
US

V. Phone/Fax

Practice location:
  • Phone: 713-791-1414
  • Fax: 713-956-0227
Mailing address:
  • Phone: 713-791-1414
  • Fax: 713-956-0227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number634769
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: