Individual
DAVISHA SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
224 SHOSHONE RIDGE DR, LA MARQUE, TX 77568-6622
(409) 454-4197
Mailing address
1155 DAIRY ASHFORD RD STE 560, HOUSTON, TX 77079-3035
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
189502
TX
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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