Krystal Deanne Williams, AGPCNP
Individual provider Active NPI Nurse Practitioner · Tatum, TX
NPI 1629924253 · NPPES record last updated Mar 6, 2026
Key facts
- NPI
- 1629924253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 1226746 (TX)
- Practice address
- 810 N Hill St Ste 5
Tatum, TX 75691-1740 - Phone
- (903) 947-2273
- NPI assigned
- Mar 6, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7100 Pines Blvd
Suite 22
Pembroke Pines, FL 33024-7394
810 N Hill St
Tatum, TX 75691-1740
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260608000829 | TX | Practitioner - Nurse Practitioner | 8325519655 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1226746 | TX | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 1226746 | TX | |
| Nurse Practitioner | 363L00000X | 1226746 | TX | Yes |
Addresses
Primary practice location
810 N Hill St Ste 5
Tatum, TX 75691-1740
Mailing address
222 Jefferson St
Beckville, TX 75631-1746
Phone (903) 824-4847
Other practice location 1
810 N Hill St Ste 3
Tatum, TX 75691-1740
Phone (903) 947-2020
Other providers in Tatum, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.