Individual
LAURA BETH DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
520 DOUGLAS BLVD, TYLER, TX 75702-8307
(903) 593-1721
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP129297
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352819201
—
TX
05
—
352819202
—
TX
05
—
352819203
—
TX
05
—
352819204
—
TX
01
—
75-0818167-015
TRICARE
TX
01
—
75-0818167-022
TRICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
75-1976930-005
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-007
TRICARE
TX
01
—
75-2616977-023
TRIUCARE
TX
01
—
75-2616977-028
TR
TX
01
—
75-2616977-118
TRICARE
TX
01
—
75-2616977-129
TRICARE
TX
01
—
8343NS
BCBS
TX
01
—
8478NY
BCBS
TX
01
—
850NY
BCBS
TX
01
—
8946NY
BCBS
TX
01
—
P01569953
RAIL ROAD MEDICARE
TX
01
—
P01707526
RAIL ROAD MEDICARE
TX
01
—
P01707529
RAIL ROAD MEDICARE
TX
Enumeration date
10/13/2015
Last updated
09/19/2025
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