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NPI Code Detail

MEDICARE: MS. EVELYN D DAVIS L.M.T., MMT

MEDICARE:  MS. EVELYN D DAVIS  L.M.T., MMT
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
1225700000XMassage TherapistMT123347TX

General Provider Information

NPI Number : 1639414675
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EVELYN D DAVIS L.M.T., MMT
Provider Business Mailing Address
First Line : 5501 INDEPENDENCE PKWY STE 318
Second Line :
City : PLANO
State : TX
Zip : 75023-5471
Country : US
Telephone Number : 469-831-9652
Fax Number :
Provider Business Practice Location Address
First Line : 5501 INDEPENDENCE PKWY STE 318
Second Line :
City : PLANO
State : TX
Zip : 75023-5471
Country : US
Telephone Number : 469-831-9652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2012
Last Update Date : 01/10/2020

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Directions to “ MS. EVELYN D DAVIS L.M.T., MMT” Practice Location

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