MEDICARE: PORCIA 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	246ZA2600X	Medical Art Specialist/Technologist

General Provider Information

NPI Number	:	1467160861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PORCIA DAVIS

Provider Business Mailing Address
First Line	:	4118 FANNIN ST STE 207
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-4808
Country	:	US
Telephone Number	:	832-377-5677
Fax Number	:

Provider Business Practice Location Address
First Line	:	4118 FANNIN ST STE 207
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-4808
Country	:	US
Telephone Number	:	832-377-5677
Fax Number	:

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

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	11/14/2022

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Directions to “ PORCIA DAVIS ” Practice Location

Language	Start Address	Practice Location

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