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NPI Code Detail

MEDICARE: SANDRA DAVIS MD, PA

MEDICARE: SANDRA DAVIS MD, PA
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1871851527
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANDRA DAVIS MD, PA
Provider Business Mailing Address
First Line : 5724 EL CAMPO AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-4646
Country : US
Telephone Number : 817-888-5946
Fax Number : 817-259-2785
Provider Business Practice Location Address
First Line : 6777 CAMP BOWIE BLVD STE 229
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-7157
Country : US
Telephone Number : 682-703-1311
Fax Number : 817-259-2785
Authorized Official
Title or Position : PRESIDENT
Name : SANDRA ECHEGOYEN DAVIS
Credential :
Telephone Number : 817-888-5946
Provider Enumeration Date : 05/01/2012
Last Update Date : 02/19/2024

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Directions to “SANDRA DAVIS MD, PA ” Practice Location

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