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General NPI Number Information
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NPI Number | 1902935778
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Entity Type | Individual
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Provider Name | MR. TERRY D'WAYNE DAVIS
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 3816 PIEDMONT RD
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City | FORT WORTH
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State | TX
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Zip | 76116
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Country | US
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Telephone | 817-731-3440
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Fax | 817-731-0212
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Provider Business Mailing Address
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Address Line | 3816 PIEDMONT RD
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City | FORT WORTH
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State | TX
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Zip | 76116-9413
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Country | US
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Telephone | 214-679-6596
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Fax |
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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 | 333300000X
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Taxonomy Name | Emergency Response System Companies
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License Number |
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License Number State |
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