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NPI Code Detail

MEDICARE: ELIZABETH JANE DAVIDSON MD

MEDICARE: ELIZABETH JANE DAVIDSON MD
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
12084P0804XChild & Adolescent Psychiatry PhysicianJ4763TX

General Provider Information

NPI Number : 1801896089
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH JANE DAVIDSON MD
Provider Business Mailing Address
First Line : 1602 10TH ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79401-2607
Country : US
Telephone Number : 806-766-0310
Fax Number : 806-744-9580
Provider Business Practice Location Address
First Line : 1602 10TH ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79401-2607
Country : US
Telephone Number : 806-766-0310
Fax Number : 806-744-9580
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 07/08/2007

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Directions to “ ELIZABETH JANE DAVIDSON MD” Practice Location

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