Provider Demographics
NPI:1730819822
Name:WILLIAMSON, NOAH ALEXANDER (AGACNP)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:ALEXANDER
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4427 STONE CHAPEL WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2451
Mailing Address - Country:US
Mailing Address - Phone:832-455-4371
Mailing Address - Fax:
Practice Address - Street 1:929 GESSNER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2515
Practice Address - Country:US
Practice Address - Phone:713-242-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1084141363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care