Organization
KELLEY DAVIS, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY MICHELLE DAVIS D.O (PRESIDENT)
(214) 374-0827
Entity
Organization
Contact information
Practice address
1251A E RED BIRD LN, DALLAS, TX 75241-2008
(214) 307-0827
(214) 307-0927
Mailing address
1251A E RED BIRD LN, DALLAS, TX 75241-2008
(214) 307-0827
(214) 307-0927
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L8319
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11568320
CAQH
TX
Enumeration date
06/24/2006
Last updated
11/30/2007
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