Individual
ANTHONY DAVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
2901 W FM 544, SUITE 140, WYLIE, TX 75098-7049
(972) 442-1177
(972) 442-1434
Mailing address
2901 W FM 544, SUITE 140, WYLIE, TX 75098-7049
(972) 442-1177
(972) 442-1434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1141802
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160309401
—
TX
01
—
659771
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/15/2005
Last updated
01/17/2022
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