Healthcare Provider Details

I. General information

NPI: 1114148988
Provider Name (Legal Business Name): DEBRA JEAN DAVIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 VICTORIA LANE
HARLINGEN TX
78550
US

IV. Provider business mailing address

300 HIDDEN VALLEY DR
WESLACO TX
78596
US

V. Phone/Fax

Practice location:
  • Phone: 956-425-9600
  • Fax:
Mailing address:
  • Phone: 956-973-9604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number610604
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: