MEDICARE: ANN WILLIAMS AGNP-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	363LG0600X	Gerontology Nurse Practitioner	AG9190224	TX

General Provider Information

NPI Number	:	1184260572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN WILLIAMS AGNP-C

Provider Business Mailing Address
First Line	:	4725 TEAL BEND BLVD UNIT 1584
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-0487
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 GREENWAY PLZ
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77046-0526
Country	:	US
Telephone Number	:	832-540-2467
Fax Number	:

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

Provider Enumeration Date	:	11/21/2019
Last Update Date	:	11/21/2019

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