MEDICARE: ANTANECIA 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	171M00000X	Case Manager/Care Coordinator		TX

General Provider Information

NPI Number	:	1942916382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTANECIA WILLIAMS

Provider Business Mailing Address
First Line	:	3431 RAYFORD RD # 200-155
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-4943
Country	:	US
Telephone Number	:	940-268-4502
Fax Number	:

Provider Business Practice Location Address
First Line	:	3431 RAYFORD RD # 200-155
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-4943
Country	:	US
Telephone Number	:	979-575-1626
Fax Number	:

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

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	04/15/2025

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