MEDICARE: BRIDGET SHAWNTAY WILLIAMS NP-C

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	363LF0000X	Family Nurse Practitioner	AP137004	TX

General Provider Information

NPI Number	:	1164912234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET SHAWNTAY WILLIAMS NP-C

Provider Business Mailing Address
First Line	:	1311 W PRESIDENT GEORGE BUSH HWY
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-1153
Country	:	US
Telephone Number	:	254-749-4314
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 W PRESIDENT GEORGE BUSH HWY
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-1153
Country	:	US
Telephone Number	:	254-749-4314
Fax Number	:

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

Provider Enumeration Date	:	05/15/2018
Last Update Date	:	07/26/2024

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