MEDICARE: JORIAN D DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95038650	CA
2	163W00000X	Registered Nurse	95303179	CA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1213944	TX
4	163WG0000X	General Practice Registered Nurse	954568	TX

General Provider Information

NPI Number	:	1013802412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORIAN D DAVIS

Provider Business Mailing Address
First Line	:	3839 BRIARGROVE LN APT 8216
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-6382
Country	:	US
Telephone Number	:	313-826-4324
Fax Number	:

Provider Business Practice Location Address
First Line	:	3839 BRIARGROVE LN APT 8216
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-6382
Country	:	US
Telephone Number	:	313-826-4324
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	03/18/2026

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