Provider Demographics
NPI:1629578521
Name:DAVIS, KADEE LYNN (BS, DC)
Entity Type:Individual
Prefix:
First Name:KADEE
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 E WHITESTONE BLVD
Mailing Address - Street 2:STE 901
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-9068
Mailing Address - Country:US
Mailing Address - Phone:512-641-1333
Mailing Address - Fax:
Practice Address - Street 1:1464 E WHITESTONE BLVD STE 901
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-9068
Practice Address - Country:US
Practice Address - Phone:512-641-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor