MEDICARE: MR. JAMES T. DAVIS III LPC-ASSOCIATE

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	101YM0800X	Mental Health Counselor	92396	TX

General Provider Information

NPI Number	:	1770266256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES T. DAVIS III LPC-ASSOCIATE

Provider Business Mailing Address
First Line	:	14855 LIBERTY ST
Second Line	:
City	:	MONTGOMERY
State	:	TX
Zip	:	77356-4631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6020 AUBURN LAKES DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-2000
Country	:	US
Telephone Number	:	832-458-7202
Fax Number	:

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

Provider Enumeration Date	:	08/10/2023
Last Update Date	:	08/10/2023

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