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18601 Lyndon B Johnson Fwy Ste 509 Mesquite TX 75150-6434 | |
| (469) 778-0022 | |
| (833) 945-1991 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 18601 Lyndon B Johnson Fwy Ste 509, Mesquite, Texas |
| Authorized Official Name and Position | Michelle D Williams (OWNER) |
| Authorized Official Contact | 4697780022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
18601 Lyndon B Johnson Fwy Ste 509 Mesquite TX 75150-6434 Ph: (469) 778-0022 | 18601 Lyndon B Johnson Fwy Ste 509 Mesquite TX 75150-6434 Ph: (469) 778-0022 |
| NPI Number | 1982221842 |
|---|---|
| Provider Enumeration Date | 06/26/2020 |
| Last Update Date | 10/19/2024 |
| Certification Date | 10/19/2024 |
| Medicare PECOS PAC ID | 6305378035 |
|---|---|
| Medicare Enrollment ID | O20241018000934 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982221842 | NPI | - | NPPES |
| Provider Name | Michelle Denise Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194298877 PECOS PAC ID: 7113459843 Enrollment ID: I20241018001305 |
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