Provider Demographics
NPI:1023033420
Name:DAVIS, EMMA L (NP)
Entity Type:Individual
Prefix:MS
First Name:EMMA
Middle Name:L
Last Name:DAVIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 SWISS AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204
Mailing Address - Country:US
Mailing Address - Phone:214-820-8700
Mailing Address - Fax:214-818-8707
Practice Address - Street 1:4501 SWISS AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204
Practice Address - Country:US
Practice Address - Phone:214-820-8700
Practice Address - Fax:214-818-8707
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX662538363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N4023OtherBCBS
TX159358401Medicaid
TX159358403Medicaid
TX159358402Medicaid
TX159358405Medicaid
TX159358404Medicaid
TX8N4023OtherBCBS
TX159358402Medicaid
TX8L26492Medicare PIN
TXTXB100103Medicare PIN
P94377Medicare UPIN
TX159358401Medicaid
TXP00862880Medicare PIN
TX8A9300Medicare PIN
TXP00163317Medicare PIN