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General NPI Number Information
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NPI Number | 1811451040
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Entity Type | Individual
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Provider Name | DEANA DAVIS
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Gender | Female
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1300 N MAIN AVE
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City | BIG LAKE
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State | TX
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Zip | 76932-3202
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Country | US
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Telephone | 325-884-3743
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Fax | 325-884-2996
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Provider Business Mailing Address
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Address Line | 1300 N MAIN AVE
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City | BIG LAKE
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State | TX
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Zip | 76932-3202
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Country | US
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Telephone | 325-884-3743
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Fax | 325-884-2996
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1136578
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1136578
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License Number State | TX
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