Provider Demographics
NPI:1407298649
Name:DAVIS, SHILA SUE (FNP)
Entity Type:Individual
Prefix:
First Name:SHILA
Middle Name:SUE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SETON PKWY STE 302
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-8003
Mailing Address - Country:US
Mailing Address - Phone:512-324-4812
Mailing Address - Fax:512-324-4728
Practice Address - Street 1:301 SETON PKWY
Practice Address - Street 2:SUITE 302
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8002
Practice Address - Country:US
Practice Address - Phone:512-324-4812
Practice Address - Fax:512-324-4728
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX678348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX878NTOtherBCBS