MEDICARE: PRISCA 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	183500000X	Pharmacist	55656	TX

General Provider Information

NPI Number	:	1770185100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCA WILLIAMS

Provider Business Mailing Address
First Line	:	6920 MARIGOLD CT
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-8922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 W MAIN ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-1929
Country	:	US
Telephone Number	:	123-456-7899
Fax Number	:

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

Provider Enumeration Date	:	11/10/2020
Last Update Date	:	02/13/2025

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Directions to “ PRISCA WILLIAMS ” Practice Location

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