1609989342 NPI number — DR. ANDREA LENETTE WILLIAMS D.D.S.

Table of content: DR. ANDREA LENETTE WILLIAMS D.D.S. (NPI 1609989342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609989342 NPI number — DR. ANDREA LENETTE WILLIAMS D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
ANDREA
Provider Middle Name:
LENETTE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHITE
Provider Other First Name:
ANDREA
Provider Other Middle Name:
LENETTE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.D.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609989342
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2708 PEARLAND PKWY
Provider Second Line Business Mailing Address:
STE: 200
Provider Business Mailing Address City Name:
PEARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77581-5351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-997-1943
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2708 PEARLAND PKWY
Provider Second Line Business Practice Location Address:
STE: 200
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77581-5351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-997-1943
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  LNO 5490 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 5490 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 24150 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)