Provider Demographics
NPI:1003024340
Name:DAVIS, CHRIS BLAKE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:BLAKE
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 LOST OAK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-5043
Mailing Address - Country:US
Mailing Address - Phone:281-221-4424
Mailing Address - Fax:
Practice Address - Street 1:2912 W DAVIS ST STE 120
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2042
Practice Address - Country:US
Practice Address - Phone:936-756-7111
Practice Address - Fax:936-444-6322
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7979111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation