Healthcare Provider Details

I. General information

NPI: 1710841432
Provider Name (Legal Business Name): JOSHUA DAVIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DEION DAVIS TRANSIT

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 W PATIN ST
BREAUX BRIDGE LA
70517-5723
US

IV. Provider business mailing address

917 W PATIN ST
BREAUX BRIDGE LA
70517-5723
US

V. Phone/Fax

Practice location:
  • Phone: 832-404-0715
  • Fax:
Mailing address:
  • Phone: 832-404-0715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: