Healthcare Provider Details

I. General information

NPI: 1609945849
Provider Name (Legal Business Name): MELISSA A WILLIAMS-TAURIAC O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 N MACARTHUR BLVD SUITE 148
IRVING TX
75039-3806
US

IV. Provider business mailing address

6823 HILLWOOD LN
DALLAS TX
75248-5032
US

V. Phone/Fax

Practice location:
  • Phone: 972-556-2929
  • Fax: 972-556-2057
Mailing address:
  • Phone: 972-556-2929
  • Fax: 972-556-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5672T
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number5672T
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: