Provider Demographics
NPI:1013802412
Name:DAVIS, JORIAN D
Entity type:Individual
Prefix:
First Name:JORIAN
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 BRIARGROVE LN APT 8216
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6382
Mailing Address - Country:US
Mailing Address - Phone:313-826-4324
Mailing Address - Fax:
Practice Address - Street 1:3839 BRIARGROVE LN APT 8216
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6382
Practice Address - Country:US
Practice Address - Phone:313-826-4324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX954568163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty