Individual
PHELIX KELLY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3636 OLD SPANISH TRL # B-1246, HOUSTON, TX 77021-2456
(281) 451-9609
Mailing address
3636 OLD SPANISH TRL # B-1246, HOUSTON, TX 77021-2456
(281) 451-9609
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
311Z00000X
Custodial Care Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
342000000X
Transportation Network Company
—
—
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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