Active NPI
Dedra Lynnette Williams, PHARMD
- Pharmacist
- Deer Park, TX
National Provider Identifier
1467734772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 42658
- Practice address
- 3300 Center St
Deer Park, TX 77536-5058 - Phone
- (281) 479-3488
- NPI assigned
- Sep 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 42658 | TX | Primary |
Addresses
Primary practice location
3300 Center St
Deer Park, TX 77536-5058
Mailing address
2013 Balsam Lake LN
Pearland, TX 77584-3623
Phone (832) 725-5803
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42658 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1467734772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2013 BALSAM LAKE LN",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775843623",
"telephone_number": "832-725-5803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 CENTER ST",
"city": "DEER PARK",
"state": "TX",
"postal_code": "775365058",
"telephone_number": "281-479-3488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DEDRA",
"middle_name": "LYNNETTE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "42658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.