Provider Demographics
NPI:1487861035
Name:DAVIDSON, FELICIA DEAJON (LVN)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:DEAJON
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15250 KINGSBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5836
Mailing Address - Country:US
Mailing Address - Phone:281-564-2285
Mailing Address - Fax:281-564-8358
Practice Address - Street 1:15250 KINGSBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5836
Practice Address - Country:US
Practice Address - Phone:281-564-2285
Practice Address - Fax:281-564-8358
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX134528164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse