Provider Demographics
NPI:1184979734
Name:DAVIS PARADIGM SHIFT, LLC
Entity type:Organization
Organization Name:DAVIS PARADIGM SHIFT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-416-2273
Mailing Address - Street 1:170 BABCOCK RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3806
Mailing Address - Country:US
Mailing Address - Phone:210-416-2273
Mailing Address - Fax:210-468-0178
Practice Address - Street 1:170 BABCOCK RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-3806
Practice Address - Country:US
Practice Address - Phone:210-416-2273
Practice Address - Fax:210-468-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-19
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care