Provider Demographics
NPI:1124007547
Name:DAVIS, MARCY FRANKS (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:FRANKS
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 BUCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-5824
Mailing Address - Country:US
Mailing Address - Phone:936-564-9449
Mailing Address - Fax:
Practice Address - Street 1:4632 NE STALLINGS DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1608
Practice Address - Country:US
Practice Address - Phone:936-560-1618
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1128007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist