Individual provider · NPI-1

Shauntavia Williams, Cranial Prosthetic

Prosthetist · Arlington, TX

NPI number1073393682
StatusActive
Last updated in NPPESOct 2, 2023

Details

NPI
1073393682
Entity type
Individual (NPI-1)
Name
Ms. Shauntavia Williams
Credential
Cranial Prosthetic
Sex
Female
Sole proprietor
No
Enumeration date
Oct 2, 2023
Certification date
Oct 2, 2023
Last updated
Oct 2, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
224P00000X Prosthetist1631040TXYes

Practice location

2813 Galleria Dr
Arlington, TX 76011-6715

Phone 972-816-3050

Mailing address

2813 Galleria Dr
Arlington, TX 76011-6715

Phone 972-816-3050

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Prosthetist providers in Arlington, TX