MEDICARE: LAKESHIA RENEE' WILLIAMS FNP-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	AP138156	TX

General Provider Information

NPI Number	:	1619445590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAKESHIA RENEE' WILLIAMS FNP-C

Provider Business Mailing Address
First Line	:	17350 STATE HIGHWAY 249
Second Line	:	STE 220
City	:	HOUSTON
State	:	TX
Zip	:	77064
Country	:	US
Telephone Number	:	409-203-5141
Fax Number	:

Provider Business Practice Location Address
First Line	:	17350 STATE HIGHWAY 249
Second Line	:	STE 220
City	:	HOUSTON
State	:	TX
Zip	:	77064-1132
Country	:	US
Telephone Number	:	409-203-5141
Fax Number	:	551-236-2496

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

Provider Enumeration Date	:	11/08/2018
Last Update Date	:	02/17/2021

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