Tyson Davis
Psychologist, Clinical in Austin, TX. Individual provider (NPI-1).
NPI number1417205774
StatusActive
Last updated in NPPESFeb 18, 2020
Details
- NPI
- 1417205774
- Entity type
- Individual (NPI-1)
- Name
- Tyson Davis
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 16, 2012
- Certification date
- Feb 18, 2020
- Last updated
- Feb 18, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- Medicare opt-out
- Jan 1, 2025 to Jan 1, 2027
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PS017720 | PA | Yes |
| 103TC0700X | Psychologist, Clinical | 38201 | TX |
Practice location
1515 S Capital Of Texas HwySte 200
Austin, TX 78746-6544
Phone 512-767-1136
Mailing address
1515 S Capital Of Texas HwySte 200
Austin, TX 78746-6544
Phone 512-767-1136
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