Individual
MS. AMANTHIA PEACE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEDORTHIST
Contact information
Practice address
3645 CALDER AVE., BEAUMONT, TX 77706
(409) 833-0053
(409) 833-0671
Mailing address
3645 CALDER AVE, BEAUMONT, TX 77706-5027
(409) 833-0053
(409) 833-0671
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3-20480-8839-0
COMPTROLLER OF PUBLIC ACCOUNTS
TX
05
—
45-5405320
—
TX
Enumeration date
08/16/2017
Last updated
07/21/2022
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