Provider Demographics
NPI:1447290903
Name:WILLIAMS, NICHOLAS PERTEATE (CPO LPO)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:PERTEATE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:CPO LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2382
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77487-2382
Mailing Address - Country:US
Mailing Address - Phone:713-828-3595
Mailing Address - Fax:281-313-4924
Practice Address - Street 1:8449 W BELLFORT ST STE 380
Practice Address - Street 2:PROSTHETIC AND ORTHOTIC PROFESSIONAL SERRVICES
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2248
Practice Address - Country:US
Practice Address - Phone:713-776-8340
Practice Address - Fax:713-776-8259
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1159222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist