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NPI Code Detail

MEDICARE: MS. SHANNON MARIE DAVIS

MEDICARE: MS. SHANNON MARIE DAVIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist36435TX

General Provider Information

NPI Number : 1598761454
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHANNON MARIE DAVIS
Provider Business Mailing Address
First Line : 420 N FRAZIER ST
Second Line :
City : CONROE
State : TX
Zip : 77301-2882
Country : US
Telephone Number : 936-494-0424
Fax Number :
Provider Business Practice Location Address
First Line : 420 N FRAZIER ST
Second Line :
City : CONROE
State : TX
Zip : 77301-2882
Country : US
Telephone Number : 936-494-0424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 09/09/2024

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Directions to “ MS. SHANNON MARIE DAVIS ” Practice Location

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