Provider Demographics
NPI:1710996152
Name:DAVIS, RITA SHAWN (DC)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:SHAWN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28427 TOMBALL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-3307
Mailing Address - Country:US
Mailing Address - Phone:281-290-7100
Mailing Address - Fax:281-255-8141
Practice Address - Street 1:28427 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-3307
Practice Address - Country:US
Practice Address - Phone:281-290-7100
Practice Address - Fax:281-255-8141
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7123DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0036KPOtherGROUP PROVIDER NUMBER
TXTPI038310102Medicaid
TX00798VOtherPROVIDER NUMBER
TXU65072Medicare UPIN
TX00798VOtherPROVIDER NUMBER