Provider Demographics
NPI:1851992994
Name:DAVIS, ANGELA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11375 S SAM HOUSTON PKWY W STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-2347
Mailing Address - Country:US
Mailing Address - Phone:832-496-5133
Mailing Address - Fax:346-291-1161
Practice Address - Street 1:11375 S SAM HOUSTON PKWY W STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-2347
Practice Address - Country:US
Practice Address - Phone:346-335-8561
Practice Address - Fax:346-291-1161
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018790363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily