Active NPI
Patrella Williamson
- Contractor
- Killeen, TX
National Provider Identifier
1902392137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 1629036
- Practice address
- 2201 W Stan Schlueter Loop
Ste a 600
Killeen, TX 76549 - Phone
- (901) 857-3181
- NPI assigned
- Jul 11, 2018
- Last updated
- Jul 11, 2018
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 1629036 | TX | Primary |
Addresses
Primary practice location
2201 W Stan Schlueter Loop
Ste a 600
Killeen, TX 76549
Mailing address
2901 Camp Cooper Dr
Killeen, TX 76549-5881
Phone (901) 857-3198
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1629036 | TX | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531267200000",
"number": "1902392137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 CAMP COOPER DR",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765495881",
"telephone_number": "901-857-3198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 W STAN SCHLUETER LOOP",
"address_2": "STE A 600",
"city": "KILLEEN",
"state": "TX",
"postal_code": "76549",
"telephone_number": "901-857-3181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "PATRELLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-11",
"last_updated": "2018-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TX",
"license": "1629036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Killeen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.