Provider Demographics
NPI:1306450960
Name:WILLIAMSCONSULTANT COM LLC
Entity type:Organization
Organization Name:WILLIAMSCONSULTANT COM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-646-1606
Mailing Address - Street 1:929 N VAL VISTA DR
Mailing Address - Street 2:STE 109 PMB 1113
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-3701
Mailing Address - Country:US
Mailing Address - Phone:602-880-0133
Mailing Address - Fax:
Practice Address - Street 1:2303 N 44TH ST STE 12-1043
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-2442
Practice Address - Country:US
Practice Address - Phone:520-661-3035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty