Provider Demographics
NPI:1255720579
Name:DAVIS, DAMION P
Entity type:Individual
Prefix:
First Name:DAMION
Middle Name:P
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 1:7254 SUMMIT PARC DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75249-4003
Mailing Address - Country:US
Mailing Address - Phone:214-458-8608
Mailing Address - Fax:
Practice Address - Street 1:17210 CAMPBELL RD
Practice Address - Street 2:#200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252
Practice Address - Country:US
Practice Address - Phone:972-250-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72816101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional