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General NPI Number Information
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NPI Number | 1043506199
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Entity Type | Individual
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Provider Name | JARED EDWARD WILLIAMS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 23225 KINGSLAND BLVD., SUITE 300
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City | KATY
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State | TX
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Zip | 77494
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Country | US
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Telephone | 281-395-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 23225 KINGSLAND BLVD STE 300
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City | KATY
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State | TX
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Zip | 77494-2890
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Country | US
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Telephone | 281-395-0400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 29598
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License Number State | TX
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