Basic Information
| Provider Information | |||||||||
| NPI: | 1316950108 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | NOELLE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5082 CARLTON PKWY | ||||||||
| Address2: | |||||||||
| City: | WAXAHACHIE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751655948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722745705 | ||||||||
| FaxNumber: | 9729375608 | ||||||||
| Practice Location | |||||||||
| Address1: | 1505 W JEFFERSON ST | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | WAXAHACHIE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751652277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729383493 | ||||||||
| FaxNumber: | 9379375608 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 02/05/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | L7258 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 00229Z | 01 | TX | MEDICARE GROUP | OTHER | 174783401 | 05 | TX | MEDICAID |