Provider Demographics
NPI:1437670163
Name:DAVIS, RUTH (DC, ATC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 HOURLESS OAKS
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2277
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1050 LAKE CAROLYN PKWY
Practice Address - Street 2:APT 2334
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3973
Practice Address - Country:US
Practice Address - Phone:210-843-4405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20000271522255A2300X
TX14624111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer