Provider Demographics
NPI:1265298004
Name:DAVIS-AVILA, OMA E (LMSW)
Entity type:Individual
Prefix:
First Name:OMA
Middle Name:E
Last Name:DAVIS-AVILA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4816 S HUMMER LN
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3110
Mailing Address - Country:US
Mailing Address - Phone:956-358-4825
Mailing Address - Fax:
Practice Address - Street 1:4816 S HUMMER LN
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3110
Practice Address - Country:US
Practice Address - Phone:956-358-4825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112482104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker