Nicole Lynne Williams, PTA

Individual provider Active NPI Physical Therapy Assistant · Dallas, TX

NPI 1649068834 · NPPES record last updated Apr 28, 2025

Key facts

NPI
1649068834
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2074490 (TX)
Practice address
7929 Brookriver Dr
Dallas, TX 75247-4900
Phone
(214) 389-6663
Fax
(214) 351-6453
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2074490TXMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
225200000X 2074490 TX Yes

Addresses

Primary practice location

7929 Brookriver Dr
Dallas, TX 75247-4900

Mailing address

415 Suffolk Dr
Grand Prairie, TX 75052-2584
Phone (214) 883-6712

Other providers in Dallas, TX

All providers in Dallas, TX · Physical Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.