MEDICARE: MALLORIE DAVIDSON FNP

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	363LP2300X	Primary Care Nurse Practitioner	000000	TX

General Provider Information

NPI Number	:	1326765819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALLORIE DAVIDSON FNP

Provider Business Mailing Address
First Line	:	4201 INTERWAY PL
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-5668
Country	:	US
Telephone Number	:	817-438-6776
Fax Number	:	469-663-5516

Provider Business Practice Location Address
First Line	:	2377 S COLLINS ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-1224
Country	:	US
Telephone Number	:	817-274-4505
Fax Number	:

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

Provider Enumeration Date	:	10/25/2022
Last Update Date	:	02/23/2026

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