Provider Demographics
NPI:1255689881
Name:DAVIS, KAYLA RENEE (PA)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:RENEE
Last Name:DAVIS
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Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 20308
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76702-0308
Mailing Address - Country:US
Mailing Address - Phone:254-537-6868
Mailing Address - Fax:254-537-6869
Practice Address - Street 1:6600 FISH POND RD
Practice Address - Street 2:SUITE 202A
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-2581
Practice Address - Country:US
Practice Address - Phone:254-732-6789
Practice Address - Fax:254-732-6790
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2014-06-19
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical