Provider Demographics
NPI:1215219530
Name:VIRGINIA L DAVIS
Entity Type:Organization
Organization Name:VIRGINIA L DAVIS
Other - Org Name:STAR CPD SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:903-885-3173
Mailing Address - Street 1:798 FARM ROAD 3019
Mailing Address - Street 2:FM 3019
Mailing Address - City:WINNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75494-4859
Mailing Address - Country:US
Mailing Address - Phone:903-885-3173
Mailing Address - Fax:903-885-5544
Practice Address - Street 1:798 FARM ROAD 3019
Practice Address - Street 2:FM 3019
Practice Address - City:WINNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75494-4859
Practice Address - Country:US
Practice Address - Phone:903-885-3173
Practice Address - Fax:903-885-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9859207QS1201X
TX60702227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Multi-Specialty