Provider Demographics
NPI:1508087347
Name:DAVIS, FREDDIE N (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDDIE
Middle Name:N
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:FREDDIE
Other - Middle Name:N
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5534 NORTH WAYSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028
Mailing Address - Country:US
Mailing Address - Phone:713-676-1110
Mailing Address - Fax:
Practice Address - Street 1:5534 NORTH WAYSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028
Practice Address - Country:US
Practice Address - Phone:713-676-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice