Individual
DR. GRACE P DAVIDSON
Active
Individual
DR. GRACE P DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2-3603
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G80Y
BLUECROSS BLUESHIELD
TX
01
—
4343549
AETNA
TX
01
—
83212P
PARKLAND MEDICARE NUMBER
TX
Enumeration date
12/07/2005
Last updated
04/29/2013
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