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Individual

CHANDRA LYN DAVENPORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
12221 MERIT DR, SUITE 1610, DALLAS, TX 75251-2202
(972) 372-0912
(214) 217-1901
Mailing address
12221 MERIT DR, SUITE 1610, DALLAS, TX 75251-2202
(972) 372-0912
(214) 217-1901

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04620
TX
363AM0700X
Medical Physician Assistant
PA04620
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3010613-01
TX
Enumeration date
10/03/2006
Last updated
01/29/2026
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