Individual
CARMEN E. DAVAILUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
17 LAKE DR, ROUND ROCK, TX 78665-9415
(512) 264-4007
Mailing address
17 LAKE DR, ROUND ROCK, TX 78665-9415
(512) 264-4007
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
722028
TX
163W00000X
Registered Nurse
RN-46825
HI
363LF0000X
Family Nurse Practitioner
Primary
AP115185
TX
363LF0000X
Family Nurse Practitioner
APRN-315
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07077
PRESCRIPTION ID #
TX
05
—
183965604
—
TX
05
—
183965605
—
TX
01
—
722028
TX LICENSE #
TX
01
—
AP115185
APRN LICENSE
TX
Enumeration date
08/08/2006
Last updated
09/22/2016
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