Magen Brook Spears Davis, RN

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

823638 Issued in TX

Practice address

755 S Beckham Ave
Tyler, TX 75701-1903

Phone

(903) 261-5208

NPI assigned

Mar 4, 2021

Last updated

Mar 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1770178550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011903",
            "telephone_number": "903-261-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEARS DAVIS",
        "first_name": "MAGEN",
        "middle_name": "BROOK",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "823638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest LTC - Waterton LLC (The Waterton Healthcare & Rehabilitation)
• Stephen C Spain, MD
• Brandi Sparks
• Jordan Nicole Sparks, COTA
• Mariellen Angela Speaker, FNP
• Lindsey Nicole Spears
• Shane Foree Spears, PA-C, CCP
• Special Health Resources for Texas Incorporated (Women's Health Tyler)
• Special Health Resources for Texas, Incorporated (Tyler Care Clinic)
• Special Health Resources for Texas, Incorporated (Midtown Clinic of Tyler)

• Pediatric Registered Nurse in Tyler, TX
• Providers in Tyler, TX by specialty
• Pediatric Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.