Healthcare Provider Details

I. General information

NPI: 1568637452
Provider Name (Legal Business Name): JANET L DAVILA AU.D., C.C.C.-A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANET L BUCK AU.D., C.C.C.-A.

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12221 N MO PAC EXPY
AUSTIN TX
78758-2401
US

IV. Provider business mailing address

12221 N MO PAC EXPY
AUSTIN TX
78758-2401
US

V. Phone/Fax

Practice location:
  • Phone: 512-901-4006
  • Fax: 512-901-3906
Mailing address:
  • Phone: 512-901-4006
  • Fax: 512-901-3906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number80030
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: