Provider Demographics
NPI:1871364570
Name:DAVIS, STEPHANI
Entity type:Individual
Prefix:
First Name:STEPHANI
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 N SHEPHERD DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-4183
Mailing Address - Country:US
Mailing Address - Phone:888-450-3033
Mailing Address - Fax:
Practice Address - Street 1:1533 N SHEPHERD DR STE 20022
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-4177
Practice Address - Country:US
Practice Address - Phone:888-450-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program