Individual
MISS FANNIE MARIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
623 FERN DRIVE, DESOTO, TX 75115-6617
(214) 849-3597
(214) 857-1281
Mailing address
623 FERN DR, DESOTO, TX 75115-6617
(214) 849-3597
(214) 857-1281
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1611
TX
Other
Enumeration date
04/27/2007
Last updated
07/08/2007
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