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NPI Code Detail

MEDICARE: KAYLEE MARIE DAVIS-BORDOVSKY MD

MEDICARE: KAYLEE MARIE DAVIS-BORDOVSKY MD
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
12084P0800XPsychiatry PhysicianS9867TX
22084P0800XPsychiatry Physician693528TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1693528OTHERTXTEXAS MEDICAL BOARD

General Provider Information

NPI Number : 1386106037
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEE MARIE DAVIS-BORDOVSKY MD
Provider Business Mailing Address
First Line : PO BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-5347
Country : US
Telephone Number : 214-645-0624
Fax Number : 214-645-0078
Provider Business Practice Location Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-456-8899
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2019
Last Update Date : 03/20/2026

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