Individual provider · NPI-1
Timothy C Davis, RN,PNP
Nurse Practitioner, Pediatrics · Brownwood, TX
NPI number1326153198
StatusActive
Last updated in NPPESNov 28, 2012
Details
- NPI
- 1326153198
- Entity type
- Individual (NPI-1)
- Name
- Timothy C Davis
- Credential
- RN,PNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2006
- Last updated
- Nov 28, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 582080 | TX | Yes |
| 363LP0222X | Nurse Practitioner, Pediatrics, Critical Care | 582080 | TX | |
| 363LN0000X | Nurse Practitioner, Neonatal | 582080 | TX | |
| 363LN0005X | Nurse Practitioner, Neonatal, Critical Care | 582080 | TX |
Practice location
104 S Park DrBrownwood, TX 76801-5918
Phone 325-646-0704 · Fax 325-646-1513
Mailing address
2330 Barberry DrDallas, TX 75211-1805
Phone 214-529-1859
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