Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 3107260 | TX |
NPI | 1114169620 |
---|---|
Provider Name | Ms. Carrie Williamson |
First Address | Austin, TX 78727-6301 |
Second Address | Austin, TX 78723-2900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2009 |
Last Update Date | 30/03/2009 |