Provider Demographics
NPI:1659150498
Name:DAVIS, SYDNEY LEIGH
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:LEIGH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 CHARLIE DR
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76273-1103
Mailing Address - Country:US
Mailing Address - Phone:903-564-3503
Mailing Address - Fax:
Practice Address - Street 1:304 CHARLIE DR
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:TX
Practice Address - Zip Code:76273-1103
Practice Address - Country:US
Practice Address - Phone:903-564-3503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1137251363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily