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General NPI Number Information
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NPI Number | 1558924100
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Entity Type | Organization
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Legal Business Name | KIM DAVIS PHD PLLC
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 04/18/2019
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Provider Practice Location Address
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Address Line | 3724 JEFFERSON ST STE 200
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City | AUSTIN
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State | TX
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Zip | 78731-6221
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Country | US
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Telephone | 512-497-2706
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Fax | 512-420-0333
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Provider Business Mailing Address
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Address Line | 3724 JEFFERSON ST STE 200
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City | AUSTIN
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State | TX
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Zip | 78731-6221
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Country | US
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Telephone | 512-497-2706
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Fax | 512-420-0333
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Authorized Official
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Title or Position | PSYCHOLOGIST OWNER
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Name | DR. KIM DAVIS
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Credential | PHD
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Telephone | 512-497-2706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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