Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 5023 | TX |
NPI | 1083756407 |
---|---|
Provider Name | Carolyn Davis Williams |
First Address | Houston, TX 77004-7813 |
Second Address | Houston, TX 77004-5250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 22/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C603350 | (05) | TX |
T85085 | (02) | TX |