Mary Ann Davis

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

00238902 Issued in TX

Practice address

803 Oakdale Ave
Longview, TX 75602-2049

Phone

(903) 917-3118

Fax

(903) 295-5856

NPI assigned

Oct 11, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1730464611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 OAKDALE AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756022049",
            "telephone_number": "903-917-3118",
            "fax_number": "903-295-5856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 OAKDALE AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756022049",
            "telephone_number": "903-917-3118",
            "fax_number": "903-295-5856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TX",
            "license": "00238902",
            "primary": true
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "TX",
            "license": "00238902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davis Medical Professionals
• David Davis, PT
• Donna Davis, MD
• Hailey Ann Davis
• Lamont A Davis, FNP
• Robert Francis Davis III, DDS
• Sandra Davis, LCDC
• Victoria Davis, RBT
• Matthew Graham Dawson
• Sarah Dawson, FNP-C

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Longview, TX
• Providers in Longview, TX by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.