Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101240232 | VA |
N | 208000000X | Pediatrician | M5500 | TX |
N | 2080P0204X | Pediatric Emergency Doctor | 0101240232 | VA |
Y | 2080P0204X | Pediatric Emergency Doctor | M5500 | TX |
NPI | 1275676660 |
---|---|
Provider Name | Jessica Sharry Williams |
First Address | Dallas, TX 75235 |
Second Address | Dallas, TX 75235-7701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 04/05/2010 |