MEDICARE: CAMILLE ANTOINETTE DAVIS PMHNP-BC

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	1059336	TX

General Provider Information

NPI Number	:	1184375289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE ANTOINETTE DAVIS PMHNP-BC

Provider Business Mailing Address
First Line	:	7548 PRESTON RD
Second Line	:	STE 141 #1245
City	:	FRISCO
State	:	TX
Zip	:	75034
Country	:	US
Telephone Number	:	251-274-8640
Fax Number	:	214-427-6598

Provider Business Practice Location Address
First Line	:	13509 LYNDON B JOHNSON FWY STE 200
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-4704
Country	:	US
Telephone Number	:	251-274-8640
Fax Number	:	214-427-6598

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

Provider Enumeration Date	:	01/11/2022
Last Update Date	:	10/14/2025

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