Provider Demographics
NPI:1053785568
Name:WILLIAMS, NATALIE SHEA (PA-C)
Entity type:Individual
Prefix:MISS
First Name:NATALIE
Middle Name:SHEA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 E IDEL ST
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-2024
Mailing Address - Country:US
Mailing Address - Phone:903-535-2902
Mailing Address - Fax:903-535-9217
Practice Address - Street 1:1020 E IDEL ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2024
Practice Address - Country:US
Practice Address - Phone:903-535-2902
Practice Address - Fax:903-535-9217
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10242363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical