Provider Demographics
NPI:1538166913
Name:WILLIAMS, ELIZABETH KAY (PT, MS)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:KAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:MR
Other - First Name:LISA
Other - Middle Name:KAY
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:3604 SPRINGMONT DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-4113
Mailing Address - Country:US
Mailing Address - Phone:432-262-3653
Mailing Address - Fax:432-685-6937
Practice Address - Street 1:2200 W ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6407
Practice Address - Country:US
Practice Address - Phone:432-685-1606
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1063410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist