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NPI Code Detail

MEDICARE: KAMETHA DAVIS

MEDICARE:   KAMETHA  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
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1841913167
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMETHA DAVIS
Provider Business Mailing Address
First Line : 7504 BERRENDA DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76131-5136
Country : US
Telephone Number : 405-501-8440
Fax Number :
Provider Business Practice Location Address
First Line : 7504 BERRENDA DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76131-5136
Country : US
Telephone Number : 405-501-8440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2022
Last Update Date : 09/21/2022

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Directions to “ KAMETHA DAVIS ” Practice Location

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