Provider Demographics
NPI:1053116178
Name:WILLIAMS, DYAMOND S
Entity type:Individual
Prefix:
First Name:DYAMOND
Middle Name:S
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4526 MUNGER AVE APT 108
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-4782
Mailing Address - Country:US
Mailing Address - Phone:469-460-0322
Mailing Address - Fax:
Practice Address - Street 1:4526 MUNGER AVE APT 108
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-4782
Practice Address - Country:US
Practice Address - Phone:469-460-0322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist