MEDICARE: MRS. MARGERINE WHITE WILLIAMS

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
1	171W00000X	Contractor	030420	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144244229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGERINE WHITE WILLIAMS

Provider Business Mailing Address
First Line	:	3138 COUNTRY CLUB BLVD
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77477-4615
Country	:	US
Telephone Number	:	713-440-0913
Fax Number	:	713-440-0919

Provider Business Practice Location Address
First Line	:	3321 DIXIE DR.
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021
Country	:	US
Telephone Number	:	713-440-0913
Fax Number	:	713-440-0913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/09/2007

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