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NPI Code Detail

MEDICARE: YSIDRA WILLIAMS M.A. CCC-SLP

MEDICARE: YSIDRA WILLIAMS M.A. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist19835TX

General Provider Information

NPI Number : 1134344393
Entity Type Code : Individual
Provider Name (Legal Business Name) : YSIDRA WILLIAMS M.A. CCC-SLP
Provider Business Mailing Address
First Line : 9308 MUSKBERRY CV
Second Line :
City : AUSTIN
State : TX
Zip : 78717-5527
Country : US
Telephone Number : 512-246-3399
Fax Number :
Provider Business Practice Location Address
First Line : 2011 W KOENIG LN
Second Line :
City : AUSTIN
State : TX
Zip : 78756-1131
Country : US
Telephone Number : 512-467-7006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2007
Last Update Date : 07/08/2007

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Directions to “ YSIDRA WILLIAMS M.A. CCC-SLP” Practice Location

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