=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073940466
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANA WILLIAMS D.P.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2013
-----------------------------------------------------
Last Update Date | 10/01/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5150 CRENSHAW RD BUILDING D100
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77505-3094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-943-1100
-----------------------------------------------------
Fax | 713-943-1178
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5150 CRENSHAW RD BUILDING D100
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77505-3094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-943-1100
-----------------------------------------------------
Fax | 713-943-1178
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 3114272
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------