Healthcare Provider Details

I. General information

NPI: 1033381785
Provider Name (Legal Business Name): DIANA LYNN WILLIAMSON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA LYNN WILLIAMSON DC

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 01/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3213 GREENWAY LN
MELISSA TX
75454-3310
US

IV. Provider business mailing address

PO BOX 772
WINNSBORO TX
75494-0772
US

V. Phone/Fax

Practice location:
  • Phone: 972-616-3447
  • Fax:
Mailing address:
  • Phone: 972-616-3447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24626
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: