Individual
MS. AUDREY CHRISTINE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 MOSSY OAK DR, IRVING, TX 75063-8420
(972) 523-1094
Mailing address
2101 MOSSY OAK DR, IRVING, TX 75063-8420
(972) 523-1094
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JQY302M96778
ANTHEM BLUE SHIELD
TX
Enumeration date
11/16/2021
Last updated
11/16/2021
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