Healthcare Provider Details

I. General information

NPI: 1598154650
Provider Name (Legal Business Name): KAREN LYNETTE WILLIAMS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN LYNETTE POPP

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4358 LOCKHILL SELMA RD STE 110
SAN ANTONIO TX
78249
US

IV. Provider business mailing address

4358 LOCKHILL SELMA RD STE 110
SAN ANTONIO TX
78249-4167
US

V. Phone/Fax

Practice location:
  • Phone: 210-492-4200
  • Fax: 210-492-4380
Mailing address:
  • Phone: 210-492-4300
  • Fax: 210-492-4380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA09610
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: