MEDICARE: PRISCILLA MARIE WILLIAMS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	146D00000X	Personal Emergency Response Attendant	TX
2	343900000X	Non-emergency Medical Transport (VAN)	TX
3	347B00000X	Bus	TX
4	347C00000X	Private Vehicle	TX

General Provider Information

NPI Number	:	1376046342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA MARIE WILLIAMS

Provider Business Mailing Address
First Line	:	P.O. BOX 300126
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77230
Country	:	US
Telephone Number	:	832-894-1606
Fax Number	:

Provider Business Practice Location Address
First Line	:	MTSS-PRISCILLA: 5921 NORTHDALE RD HOUTX 77087
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087
Country	:	US
Telephone Number	:	832-894-1606
Fax Number	:

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

Provider Enumeration Date	:	03/15/2018
Last Update Date	:	07/21/2022

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