Healthcare Provider Details

I. General information

NPI: 1306480371
Provider Name (Legal Business Name): KAI DAVIS PROSTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2019
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N COIT RD STE 2078
RICHARDSON TX
75080-6221
US

IV. Provider business mailing address

500 N COIT RD STE 2078
RICHARDSON TX
75080-6221
US

V. Phone/Fax

Practice location:
  • Phone: 214-897-3585
  • Fax: 214-242-2240
Mailing address:
  • Phone: 214-897-3585
  • Fax: 214-242-2240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. KAI GREGORY DAVIS
Title or Position: OWNER/DIRECTOR
Credential: CP
Phone: 214-897-3585