Healthcare Provider Details

I. General information

NPI: 1972165314
Provider Name (Legal Business Name): TIFFANY ASHLEY WILLIAMS CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2019
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16723 HUEBNER RD
SAN ANTONIO TX
78248-2351
US

IV. Provider business mailing address

903 W MARTIN ST # MS 49-2
SAN ANTONIO TX
78207-0903
US

V. Phone/Fax

Practice location:
  • Phone: 210-644-3600
  • Fax:
Mailing address:
  • Phone: 201-358-5909
  • Fax: 210-358-5940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP141825
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: