MEDICARE: NARTARSHA DAVIS HAIR LOSS SPECIALIST

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	1744P3200X	Prosthetics Case Management	1166570	TX

General Provider Information

NPI Number	:	1508208968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NARTARSHA DAVIS HAIR LOSS SPECIALIST

Provider Business Mailing Address
First Line	:	17106 WESTMINSTER VILLAGE CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-6476
Country	:	US
Telephone Number	:	832-607-4247
Fax Number	:	281-857-6703

Provider Business Practice Location Address
First Line	:	8560 HIGHWAY 6 N
Second Line	:	SUITE #603
City	:	HOUSTON
State	:	TX
Zip	:	77095-2242
Country	:	US
Telephone Number	:	832-607-4247
Fax Number	:	281-857-6703

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

Provider Enumeration Date	:	07/25/2013
Last Update Date	:	07/25/2013

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