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General NPI Number Information
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NPI Number | 1932795242
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Entity Type | Organization
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Legal Business Name | WILLIAMSON FAMILY HEALTH
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 1216 ELLIS AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3326
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Country | US
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Telephone | 936-632-6184
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Fax | 936-632-7836
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Provider Business Mailing Address
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Address Line | 1216 ELLIS AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3326
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Country | US
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Telephone | 936-632-6184
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Fax | 936-632-7836
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Authorized Official
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Title or Position | OWNER
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Name | JUDD FREDERICK WILLIAMSON
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Credential | APRN, FNP-C
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Telephone | 936-208-5786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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