MEDICARE: DR. ASHLEY DAVIS DPT

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	225100000X	Physical Therapist	1246425	TX

General Provider Information

NPI Number	:	1700251535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY DAVIS DPT

Provider Business Mailing Address
First Line	:	508 GREEN POINTE DRIVE
Second Line	:
City	:	HUDSON OAKS
State	:	TX
Zip	:	76087
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7001 BRYANT IRVIN RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4243
Country	:	US
Telephone Number	:	817-756-1796
Fax Number	:

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

Provider Enumeration Date	:	12/04/2015
Last Update Date	:	04/28/2016

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