Provider Demographics
NPI:1871983536
Name:WILLIAMS, GERTHA
Entity type:Individual
Prefix:
First Name:GERTHA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 GENTLE BEND DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-4111
Mailing Address - Country:US
Mailing Address - Phone:713-530-9754
Mailing Address - Fax:281-437-6712
Practice Address - Street 1:1427 GENTLE BEND DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-4111
Practice Address - Country:US
Practice Address - Phone:713-530-9754
Practice Address - Fax:281-437-6712
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12922171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator