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NPI Code Detail

MEDICARE: ADORNA DAREESE DAVIDSON

MEDICARE:   ADORNA DAREESE DAVIDSON
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
1164X00000XLicensed Vocational Nurse331359TX

General Provider Information

NPI Number : 1396405619
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADORNA DAREESE DAVIDSON
Provider Business Mailing Address
First Line : 14203 LONG MEADOW DR
Second Line :
City : HOUSTON
State : TX
Zip : 77047-4598
Country : US
Telephone Number : 512-630-4198
Fax Number :
Provider Business Practice Location Address
First Line : 14203 LONG MEADOW DR
Second Line :
City : HOUSTON
State : TX
Zip : 77047-4598
Country : US
Telephone Number : 512-630-4198
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2021
Last Update Date : 12/28/2021

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Directions to “ ADORNA DAREESE DAVIDSON ” Practice Location

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