Provider Demographics
NPI:1538449889
Name:WILLIAMS, KATHLEEN (PT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3309 ALTRICK DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8089
Mailing Address - Country:US
Mailing Address - Phone:214-317-8182
Mailing Address - Fax:
Practice Address - Street 1:3362 FOREST LN
Practice Address - Street 2:SUITE 304
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7796
Practice Address - Country:US
Practice Address - Phone:888-440-4987
Practice Address - Fax:281-894-5501
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1176380225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist