Individual
DR. CARLOS WADE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5452 GLEN LAKES DR, #202, DALLAS, TX 75231-4338
(214) 691-4244
(214) 691-1059
Mailing address
5452 GLEN LAKES DR, #202, DALLAS, TX 75231-4338
(214) 691-4244
(214) 691-1059
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
21907
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067891
VALUE OPTIONS
TX
Enumeration date
04/04/2007
Last updated
07/08/2007
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