Provider Demographics
NPI:1730840414
Name:WILLIAMS, OLIVIA CYMONE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CYMONE
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 1:990 CYPRESS STATION DR APT 1407
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-1549
Mailing Address - Country:US
Mailing Address - Phone:346-405-2725
Mailing Address - Fax:
Practice Address - Street 1:6407 LAURA KOPPE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016
Practice Address - Country:US
Practice Address - Phone:832-670-1774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)